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"Pada penderita kanker paru terjadi inflamasi sistemik dan dapat dilihat dengan peningkatan rasio netrofil limfosit di mana pemeriksaan ini lazim dilakukan di Rumah Sakit. Inflamasi sitemik dapat menyebabkan anoreksi sehingga asupan pada penderita kanker paru menurun dan memengaruhi status gizinya. Kejadian malnutrisi yang tinggi pada pasien paru dapat berakibat lamanya rawat inap, turunnya kualitas hidup, dan dapat memengaruhi keberhasilan terapi kanker sehingga terapi nutrisi yang cepat dan tepat sangat perlu dilakukan. Salah satu diagnostik status gizi pada penderita kanker yaitu dengan menggunakan kriteria ASPEN yang terdiri dari penurunan asupan, penurunan berat badan, penurunan massa otot dan massa lemak subkutan, akumulasi cairan general atau lokal, dan kapasitas fungsional. Dikatakan malnutrisi jika terdapat dua dari enam kriteria tersebut. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui hubungan status gizi dengan rasio netrofil limfosit pada pasien kanker paru di RSUP Persahabatan. Data diambil dari wawancara, pemeriksaan fisis, pemeriksaan laboratorium, dan rekam medis pasien poliklinik onkologi RSUP Persahabatan (n =52). Pada penelitian ini subjek sebagian besar berjenis laki-laki (61,5%), rentang usia terbanyak antara 50-60 tahun (38,5%), memiliki riwayat merokok (55,8%) dengan indeks Brinkman berat (30,8%). Lebih dari 50% subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Sebagian besar subjek penelitian berisiko malnutrisi atau malnutrisi sedang (38,5%) dan sebanyak 67,3% mengalami malnutrisi. Pada penelitian ini subjek dengan nilai rasio netrofil limfosit tinggi sebanyak 38,5% dan rendah sebanyak 61,5%. Tidak terdapat hubungan antara status gizi dengan rasio netrofil limfosit pada penelitian ini (p = 0,35).

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Systemic inflammation in patients with lung cancer can be seen by the increase in the neutrophil lymphocyte ratio where these examinations are common in hospitals. Systemic inflammation can cause anorexia, with the result that nutrition intake of lung cancer patients decreases and affects their nutritional status. High incidence of malnutrition in lung cancer patients can result in length of stay, decreased quality of life, and can affect the treatment of cancer therapy, therefore prompt and appropriate nutritional therapy is essential. One of the diagnostics of nutritional status for lung cancer patients is by using the ASPEN criteria which consist of decreased nutritional intake, weight loss, decreased muscle mass and subcutaneous fat mass, general or local fluid accumulation, and functional capacity. Malnutrition can be seen if there are two of the six criteria. This study is a cross-sectional study which aimed to determine the association between nutritional status and the ratio of lymphocyte neutrophils in lung cancer patients at Persahabatan Hospital. Data were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology polyclinic of Persahabatan Hospital (n = 52). The subjects of the study were mostly male (61.5%), the largest age range was between 50-60 years (38.5%), had a history of smoking (55.8%) with a severe Brinkman index (30.8%). More than 50% of the subjects with energy and protein intake were below the recommended intake for cancer patients. Most of the study subjects were at risk of malnutrition or moderate malnutrition (38.5%) and 67.3% of them were experiencing malnutrition. The subjects with the highest neutrophil lymphocyte ratio value were 38.5% and the lowest value were 61.5%. Overall, there was no relationship between nutritional status and the ratio of neutrophil to lymphocytes in this study (p = 0.35)."

"Pada penderita kanker paru terjadi inflamasi sistemik dan dapat dilihat dengan peningkatan rasio netrofil limfosit di mana pemeriksaan ini lazim dilakukan di Rumah Sakit. Inflamasi sitemik dapat menyebabkan anoreksia sehingga asupan pada penderita kanker paru menurun dan memengaruhi status gizinya.  Penelitian ini bertujuan untuk mengetahui hubungan antara status gizi dengan rasio netrofil limfosit pada pasien kanker paru di RSUP Persahabatan. Penelitian ini menggunakan desain cross-sectional. Data diambil dari wawancara, pemeriksaan fisik, pemeriksaan laboratorium, dan dari rekam medis pasien poliklinik onkologi RSUP Persahabatan (n=52). Pada penelitian ini subjek sebagian besar berjenis laki-laki (61,5%), rentang usia terbanyak antara 50-60 tahun (38,5%), memiliki riwayat merokok (55,8%) dengan indeks Brinkman berat (30,8%). Lebih dari 50% subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Sebagian besar subjek penelitian berisiko malnutrisi atau malnutrisi sedang (38,5%) dan sebanyak 67,3% mengalami malnutrisi. Sebagai kesimpulan tidak terdapat hubungan antara status gizi dengan rasio netrofil limfosit pada penelitian ini (p = 0,35).

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Systemic inflammation in patients with lung cancer can be seen by the increase in the neutrophil lymphocyte ratio where these examinations are common in hospitals. Systemic inflammation can cause anorexia, with the result that nutrition intake of patients with lung cancer decreases and affects their nutritional status. This study aims to determine the association between nutritional status and the ratio of lymphocyte neutrophils in patients with lung cancer at Persahabatan Hospital. This is a cross-sectional study. Data were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology clinic of Persahabatan Hospital (n = 52) The subjects of the study were mostly male (61.5%), the largest age range was between 50-60 years (38.5%), had a history of smoking (55.8%) with a severe Brinkman index (30.8%). More than 50% of the subjects with energy and protein intake were below the recommended intake for cancer patients. Most of the study subjects were at risk of malnutrition or moderate malnutrition (38.5%) and 67.3% of them were experiencing malnutrition. In conclusion, there was no relationship between nutritional status with the ratio of neutrophil to lymphocytes in this study (p = 0.35)."

"[ABSTRAKGaster merupakan organ pencernaan yang salah satu fungsinya sebagai penampungmakanan. Keganasan dapat terjadi di sepanjang saluran pencernaan termasuk gaster.Operasi merupakan salah satu modalitas terapi yang dipakai sebagai terapi keganasangaster. Penderita keganasan gaster akan mengalami perubahan status gizi. Data mengenaigambaran status gizi pasien yang menjalani operasi keganasan gaster belum ada diRSCM.Jenis penelitian ini adalah deskriptif retrospektif dengan mengumpulkan data rekammedis pada pasien dengan diagnosis keganasan gaster yang menjalani operasi di RumahSakit dr Cipto Mangunkusumo selama periode tahun 2009 sampai dengan 2012.HASILDari 30 pasien yang didiagnosis keganasan gaster , didapatkan data yang lengkap 19(63,3 %). Penderita laki laki, usia tua dan jenis keganasan dominan pada penelitian inisesuai dengan penelitian Leonard A Laisang tahun 2008 dan kepustakaan.5,19Terdapat peningkatan jumlah operasi pada kegansan gaster dari tahun 2009 sampaidengan 2011 namun terjadi penurunan pada tahun 2012. Rerata waktu tunggu operasicukup lama sampai 14,15 hari sedangkan rerata lama rawat 28 hari. Kebanyakan pasienberdomisili di jabodetabek dan sepertiganya dari luar jawa. Jenis operasi kebanyakanadalah parsial gastrektomi baik dengan bypass atau tidak. Perbandingan rerata albumindan IMT saat masuk rumah sakit, sebelum operasi dan setelah operasi mengalamipenurunan. Sedangkan perbandingan rerata Total Limfosit Count saat masuk rumahsakit dan sebelum operasi mengalami penurunan dan meningkat kembali setelah operasi.Pada penelitian ini terdapat dua kali lipat pasien menderita malnutrisi dibandingkanpenelitian oeh Rofi dan Kalis.15,16Kelengkapan data mengenai status nutrisi pada status rekam medis sangat diperlukan.Hasil penelitian bersesuaian dengan kepustakaan dan penelitian sebelumnya.5,19 Lamanyamenunggu operasi dan lama rawat memerlukan perhatian khusus untuk menguranginya.

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ABSTRACTGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it.;BACKGROUNDGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it., BACKGROUNDGaster is a digestive organ that is one of its functions as a container for food. Malignancymay occur along the digestive tract, including the stomach. Operation is one that is usedas a therapeutic modality therapy of gastric malignancy. Patients with gastric malignancywill change the nutritional status. Data on the picture of the nutritional status of patientswho underwent surgery for gastric malignancy not yet available at RSCM.METHODThis research is a descriptive retrospective medical record by collecting data on patientswith a diagnosis of gastric malignancy who underwent surgery at the Hospital Dr. CiptoMangunkusumo during the period from 2009 to 2012.THE RESULTOf the 30 patients diagnosed with gastric malignancy, obtained complete data 19(63.3%). Patients men, old age and type of malignancy dominant in this study isconsistent with research Leonard A Laisang 2008 and literature. 5.19There are an increasing number of operations on gastric malignancy from 2009 to 2011but decreased in 2012. The mean waiting time operation long enough to 14.15 days, whilethe average length of 28 days. Most patients live in Jabodetabek and a third from outsideJava. This type of surgery is mostly partial gastrectomy with bypass or not. A comparisonof the albumin and BMI at admission, before surgery and after surgery decreased.Meanwhile, the average ratio of Total Lymphocyte Count on admission and beforesurgery decreased and increased again after the operation. In this study, there are two-foldcompared to patients suffering from malnutrition research by Rofi and Kalis.15,16CONCLUSIONCompleteness of data on nutritional status on the status of medical records is needed.Results consistent with the literature study and research previously.5,19 The waiting list ofsurgery and length of stay require special attention to reduce it.]"

"Homeostasis protein berperan penting dalam memperlambat proses malnutrisi dan dalam mempertahankan massa bebas lemak pasien kanker. Kehilangan signifikan massa bebas lemak terutama massa otot skelet akan mengurangi mobilitas fisik, kapasitas fungsional, dan skor kualitas hidup pasien kanker. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui korelasi antara asupan protein dengan massa bebas lemak dan kapasitas fungsional pada pasien kanker paru di poli onkologi RS Persahabatan Jakarta. Didapatkan 52 subjek laki-laki dengan rerata usia 55,63 6,77 tahun. Jenis dan stadium kanker yang terbanyak ditemukan adalah adenokarsinoma 63,5, stadium IV 65,4. Status nutrisi kurang berdasarkan IMT ditemui pada 21,2 subjek, dan berdasarkan kadar albumin serum didapatkan 30,8 subjek dengan hipoalbuminemia. Lebih dari 50 subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Pada pemeriksaan komposisi tubuh didapatkan rerata massa bebas lemak 47,20 6,28 kg, dengan 48,1 indeks massa bebas lemak rendah, massa otot rerata 44,74 5,98 kg dengan 40,4 massa otot tergolong kurang. Nilai kapasitas fungsional skala Karnofsky.

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The homeostasis of protein plays an important role in decreasing the process of malnutrition and in maintaining fat free mass in cancer patients. The significant loss of fat free mass, especially skeletal muscle mass could decrease physical activity, functional capacity, and quality of life of cancer patients. This was a cross sectional study aimed to investigate the correlation of protein intake, fat free mass and functional capacity in lung cancer patients in the Oncology Unit of Persahabatan Hospital Jakarta. Obtained 52 male subjects with a mean age of 55,63 6,77 years old. The most cancers type were adenocarcinoma 63,5 and most of subjects were at stage IV 65,4 . Nutritional status of the subjects 21,2 were in undernutrition based on body mass index parameter, and 30,8 of the subjects were in hypoalbuminemia. More than 50 of the subjects had low energy and protein intake. The mean of fat free mass was at 47,20 6,28 kg, that 48,1 of fat free mass index were in low categorized, and 40,4 of muscle mass were also in small categorized, that the mean was at 44,74 5,98 kg. Functional capacity Karnofsky scale of the subjects 26,9 showed less than 70. The data showed that the subjects had nutrition problems. This study showed positive and significant correlations between protein intake with fat free mass index r 0,379, p "

"Latar Belakang: Mendeteksi risiko kejadian malnutrisi didapat dirumah sakit pada anak dapat dilakukan dengan menggunakan alat penilaian nutrisi yang dilakukan selama masa rawat anak di rumah sakit. Salah satu alat penilaian yang telah dihasilkan berupa Alarm Malnutrisi. Penelitian ini bertujuan untuk menguji nilai sensitivitas dan spesifisitas alat penilaian Alarm Malnutrisi dalam mendeteksi risiko kejadian malnutrisi didapat di rumah sakit yang dibandingkan dengan alat penilaian Screening Tool for the Risk On Nutritional Status and Growth (STRONGKids).Metode Penelitian: Penelitian dengan desain Cross Sectional ini melibatkan 168 anak yang dirawat di rumah sakit berusia 1 bulan hingga 18 tahun. Analisis data menggunakan pendekatan penelitian diagnostik yang menghasilkan nilai uji sensitivitas dan uji spesifisitas.Hasil: Hasil uji statistik menunjukan nilai uji sensitivitas dan uji spesifisitas Alarm Malnutrisi masing-masing sebesar 32,2% dan 81,6%. Hasil ini dinilai tidak begitu baik dibandingkan alat penilaian STRONGKids yang sebelumnya telah dipakai di rumah sakit.Kesimpulan: Alarm Malnutrisi masih perlu dikembangkan dan diperbaiki kembali untuk penyempurnaan sehingga dapat dipakai dengan baik dalam menilai risiko malnutrisi didapat di rumah sakit

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Background: Detecting the risks for hospital-acquired malnutrition in children can be performed by using nutritional screening tools. One of the screening tools that has been created is Alarm Malnutrisi. This study aimed to test the sensitivity and specificity of Alarm Malnutrisi in detecting the risks for hospital-acquired malnutrition in comparison to Screening Tool for the Risk On Nutritional status and Growth (STRONGkids).

Materials and Method: This study employed cross sectional design and involved 168 hospitalized children (1 month to 18 years) at pediatric ward . The data were analyzed using diagnostic approach which resulted in sensitivity and specificity values.

Results: The statistical tests showed that the sensitivity and specificity values of Alarm Malnutrisi were 32,2% and 81,6% respectively meanwhile the values of STRONGKids. These results indicated that this screening tool was not better than STRONGkids which has been previously used in the Dr. Cipto Manunkusumo Hospitals in Indonesia.

Conclusions: Alarm Malnutrisi needs to be developed and improved in order to achieve better performance in detecting the risks for hospital-acquired malnutrition."

"ABSTRAKLatar Belakang : Paduan kemoterapi berbasis platinum dengan generasi ketiga khususnya karboplatin-vinorelbin sudah sering digunakan sebagai kemoterapi paliatif pada pasien KPKBSK stage lanjut di Indonesia khususnya Rumah Sakit Umum Pusat RSUP Persahabatan namun sampai saat ini belum terdapat data mengenai efikasi dan toksisiti paduan kemoterapi ini di RSUP Persahabatan.Metode : Desain penelitian ini adalah survey observasional retrospektif pada pasien KPKBSK stage lanjut IIIB dan IV yang menjalani kemoterapi lini I di RSUP Persahabatan dengan paduan kemoterapi karboplatin-vinorelbin sejak 1 Januari 2015 sampai 30 Maret 2017.Hasil : Total subjek dalam penelitian ini adalah 38 pasien yang mendapatkan paduan kemoterapi Karboplatin AUC-5 pada hari ke-1 dan vinorelbin 30 mg/m2 pada hari ke1 dan ke-8. Paduan kemoterapi karboplatin-vinorelbin mempunyai efikasi yang baik dengan Objective overall response rate ORR 12,5 dan clinical benefit rate CBR 87,5 . Overall survival OS pada penelitian ini adalah 34,2 dengan masa tengah tahan hidup 387 hari 12,9 bulan dan progression free survival 323 hari 10,7 bulan. Toksisiti hematologi dan nonhematologi yang paling sering terjadi adalah anemia derajat 1 38,4 dan keluhan mual, muntah derajat 2 57,9 . Pada penelitian ini terdapat 2 kasus perdarahan saluran cerna derajat 2 namun pasien masih dapat melanjutkan kemoterapi. Kami juga mendapatkan komplikasi tindakan kemoterapi berupa phlebitis ringan pada 24 pasien 65,7 dan phlebitis sedang pada 1pasien 2,6 .Kesimpulan: Paduan karboplatin-vinorelbin sebagai kemoterapi lini I memiliki efikasi yang baik serta efek toksisiti yang masih dapat ditoleransi sehingga aman diberikan pada pasien KPKBSK stage lanjut. Kata kunci: efikasi, toksisiti, hematologi, nonhematologi, objective overall response rate, clinical benefit rate, overall survival, MTTH, TTP, PFS

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ABSTRAK Background Combination of platinum base and third generation drugs Carboplatin and vinorelbine chemotherapy are frequently used as paliative chemotherapy for Non small cell lung cancer NSCLC patients in Indonesia especially in Persahabatan Hospital. But there are still no data about the activity and tolerability of this regiment in Persahabatan Hospital. This study is conducted to evaluate the efficacy and toxicity of this regiment as first line chemotherapy for advanced NSCLC patients in Persahabatan Hospital.Method This study is an observational survey retrospective study for advanced NSCLC patientswho receive carboplatin vinorelbine regiment as fisrt line chemotherapy since 1st January 2015 to 30th March 2017.Result We observea total of 38 patients who receive carboplatin 5 AUC on day 1 and vinorelbine 30mg m2 on day 1 and 8. This regiment has a good efficacy with overall response rate ORR 12,5 and clinical benefit rate CBR 87,5 . The overall survival OS is 34,2 with median of survival time 387 days 12,9 moths and PFS 323 days 10,7 moths . We found grade 1 anemia 38,4 and grade 2 nausea vomiting 57,9 as hematological and non hematological toxicity that frequently occur in this study. We found 2 cases of grade 2 gastrointestinal bleeding but the patients are still able to continue the chemotherapy after doing some correction for the haemoglobin Hb . We also found mild phlebitis in 24 patients 65,7 and 1 moderate phlebitis in 1 patient 2,6 as procedural complication of this chemotherapyConclusion Combination ofcarboplatin and vinorelbine as first line chemotherapy has a good efficacy and tolerability for advanced NSCLC patients. Key word efficacy, toxicity, haematological, non hematological, overall objective response rate ORR , clinical benefit rate CBR , overall survival OS , median time of survival, time to progression TTP and progression free survival PFS ."

"ABSTRAKPendahuluan: Infeksi paru merupakan penyebab morbiditas dan mortalitas terbesar di Intensive Care Unit ICU. Pasien ICU umumnya dalam kondisi critically ill dan riwayat penggunaan antibiotic sebelumnya sehingga memiliki risiko resistensi terhadap antibiotik yang berpengaruh terhadap luaran pasien.Sistem skoring digunakan di ICU untuk menilai derajat keparahan penyakit dan luaran pasien. Penelitian ini menilai eta kuman pasien infeksi paru dan hubungannya dengan derajat keparahan penyakit yang dinilai dengan skor APACHE II. Metode: Penelitian ini menggunakan metode potong lintang yang dilaksanakan pada bulan Agustus-September 2017 di ICU RSUP Persahabatan. Total subjek terdiri atas 59 subjek dengan cara pengambilan sampel consecutive sampling. Semua pasien didiagnosis infeksi paru oleh dokter spesialis dan dikonfirmasi melalui foto toraks kemudian dinilai derajat keparahan penyakit dengan skor APACHE II dan dilakukan biakan dan resistensi mikroorganisme. Hasil: Kuman yang banyak ditemukan merupakan gram negative (37,2%) dengan risiko mortalitas tertinggi 75% jenis Acinetobacter pada skor (APACHE II 30-34). Rerata skor APACHE II 15,78+ 6,04 dengancut off point skor APACHE II 16,5 dan skor APACHE II >16 memiliki mortalitas terbesar (64%) (p=0,032). Diagnosis infeksi paru dengan mortalitas terbesar didapatkan pada CAP (56%). Kesimpulan: Acinetobacter baumanii merupakan kuman terbanyak yang menyebabkan kematian pada pasien infeksi paru dan skor APACHE II merupakan prediktor yang baik dalam menilai derajat keparahan penyakit dan luaran pasien.

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ABSTRACT<>br>Introduction: Lung infection are the most common cause of high mortality and morbidity in Intensive Care Unit (ICU). Patients in ICU mostly critically ill with history of antibiotic use and risk of drug resistant that will influence the outcome of the patients. Scoring system used in ICU to measure severity of the disease and the outcome of the patients. This study asseses the microbiological pattern of patients with lung infection and severity of the disease using APACHE II Score. Methods: This study used cross sectional methods that heldbetween August 2017-September 2017in Persahabatan Hospital Intensive Care Unit. Total subjects consisted of 59 patients with lung infection base on consecutive sampling. All of the patients diagnosed with lung infection from specialist and confirmed with radiological findings, measured the APACHE II Score and performed sputum culture and resistance. Results: The most common isolation found in lung infection patients was gram negative (37,2%) with mortality risk of Acinetobacter baumanii75% (APACHE II Score 30-34). Mean APACHE II Score was 15,78+ 6,04 with cut off point APACHE II Score 16,5 and APACHE II Score > 16 has the highest mortality (64%) (p=0,032). Diagnose of lung infection with the highest mortality found in patients with CAP (56%). Conclusions: Acinetobacter baumanii are the most common cause of mortality in lung infection patients. The APACHE II Score has good predictor in measure severity of the diseases and the outcome of the patients."

"ABSTRAKLatar belakang: Penyebab kematian pada kanker paru seringkali tidak tergambarkan dengan jelas. Penelitian ini untuk mengetahui gambaran penyebab kematian pada kanker paru dan faktor-faktor yang mempengaruhinya di RS Persahabatan dan untuk mengetahui kesesuaian antara penyebab kematian yang terdapat dalam lembar kematian dengan penyebab kematian sesuai dengan audit kematian. Metode: Penelitian potong lintang ini dilakukan di RS Persahabatan dengan subjek penelitian adalah semua pasien kanker paru yang mengalami kematian pada Januari 2010 – Desember 2011. Penyebab kematian langsung dan tidak langsung pada pasien kanker paru dicatat dari rekam medis kemudian dilakukan audit kematian dan dinilai kesesuaian dengan penyebab kematian langsung dan tidak langsung yang tertulis di rekam medis dengan audit kematian. Hasil: Total data kematian dari 96 rekam medis. Penyebab kematian langsung berdasarkan rekam medis adalah efusi pleura masif 19 kematian (19,8%) sedangkan penyebab kematian tidak langsung menurut rekam medis adalah sepsis s 44 kematian (45,8%) Sementara itu, penyebab kematian langsung berdasarkan audit kematian terbanyak adalah efusi pleura masif 48 kematian (50%), penyebab kematian tidak langsung menurut audit kematian adalah sepsis 16 kematian (16,7%). Lembar kematian yang sesuai dengan rekam medis adalah 43 kasus (44,8%) dan yang tidak sesuai 53 kasus (55,2%) sedangkan SOP yang dijalankan adalah 37 kasus (38,5%) dan SOP yang tidak dijalankan 59 kasus (61,5%). Alasan mengapa SOP tidak dijalankan adalah karena keadaan umum pasien yaitu 12 kasus (20,3%) sedangkan karena biaya dan administrasi 47 kasus (79,6%). Dari hasil uji statistik yang menilai hubungan antara SOP yang dijalankan dengan faktor pembiayaan ternyata tidak didapatkan hubungan yang bermakna (p=0,48). Diskusi : Audit kematian memang bukan standar baku emas penentuan penyebab kematian melainkan dengan autopsi klinis. Dalam konteks sosial dan budaya di Indonesia, autopsi klinis tidak mudah dilakukan sebagai penentu penyebab kematian. Dalam penelitian ini audit kematian mempunyai peran jaminan dan kendali mutu layanan kesehatan. Ketidaksesuaian penyebab kematian antara rekam medis dan kematian, serta seberapa banyak SOP yang dijalankan dan mengapa SOP tidak dijalankan dapat diungkapkan. Walaupun dari penelitian ini menunjukkan tidak terdapat hubungan bermakna antara faktor pembiayaan dengan SOP yang dijalankan atau tidak..

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ABSTRACTIntroduction: The causes of death for patients with lung cancer were inadequately described. This study objectives were to describe the causes of death in lung cancer and contributing factors in Persahabatan Hospital and to describe discrepancies between the causes of death from medical records and death audit. Method: A cross sectional study was held in PersahabatanHospital involving lung cancer patients who were died between January 2010 to December 2011. The immediate and indirect causes of death from medical records were assessed and compared with death audit. The discrepancies between were analysed. Result: A total of 96 cases were found from medical record, massive pleural effusion was found as the immediate causes in 19 cases (19.8%), while sepsis was found as the indirect causes 44 cases (45.8%). From the death audit, massive pleural effusion was found as immediate causes in 48 cases (50%), while sepsis was found asthe indirect causes 16 cases (16.7%). The discrepancies between both were found in 53 cases (55.2%). SOP was executed in 37 cases (38.5%) and unexecuted in 59 cases (61.5%). The reason of unexecuted SOP due to cost was found in 47 cases (79.6%). There is no significant correlation between the executed SOP with cost was found in factors (p=0.48). Discussion : The death audit is not the gold standard method in determining the causes of death but the clinical autopsy. This study reveals that death audit have roles inhealth care quality control and assurance. The causes of death discrepancies, the unexecueted SOP, and why SOP could not be executed could be revealed from this study."

"ABSTRAKLatar Belakang:Penelitian ini merupakan studi awal untuk menetapkan proporsi pneumonitis radiasi pada pasien kanker paru yang mendapat radiasi di RSUP Persahabatan.Metode: Penelitian ini menggunakan desain retrospektif pada pasien kanker paru yang mendapat radiasi di RSUP Persahabatan antara Juni 2013-Juli 2015. Pengambilan data melalui rekam medik dan dilakukan evaluasi ulang foto toraks 1 bulan pasca radiasi.Hasil: Terdapat 33 pasien kanker paru yang memenuhi kriteria inklusi. Karakteristik subyek meliputi usia ≥51 tahun (63,6%), laki-laki (66,7%), riwayat merokok (75,8%), IB sedang (60%), dosis radiasi 300-4000 (60,6%), fraksi radiasi 10-19 (60,6%), tidak mempunyai riwayat kemoterapi (54,5%), kanker paru jenis adenokarsinoma (66,7%) dan stage IV (84,84%). Proporsi pneumonitis radiasi berdasarkan foto toraks sebesar 39,4% yang terdiri dari gambaran hazy ground glass opacities, hazy ground glass opacities dan fibrosis serta fibrosis. Ditemukan perbedaan bermakna antara usia, dosis radiasi dan riwayat kemoterapi dengan kejadian pneumonitis radiasi (p<0,05).Kesimpulan: Proporsi pneumonitis radiasi berdasarkan foto toraks sebesar 39,4%. Terdapat perbedaan bermakna antara usia, dosis radiasi dan riwayat kemoterapi dengan kejadian pneumonitis radiasi.

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ABSTRACTIntroduction: This is a preliminary study to determine proportion radiation pneumonitis in lung cancer patients who got radiaton in Persahabatan Hospital.Method: This was a retrospective study in lung cancer patients who got radiation in Persahabatan Hospital between June 2013 ? July 2015. Interpretation data were from medical record and did reevaluation chest x ray 1 month after radiation.Result: There were 33 lung cancer patients were filled inclusion criteria. Subjects characteristic were age ≥51 years (63,6%), male (66,7%), history of smoking (75,8%), moderate IB (60%), radiation doses 3000-4000 (60,6%), radiation fractions 10-19 (60,6%), had no history of chemotheraphy (54,5%), adenocarcinoma (66,7%) and stage IV (84,84%). Proportion radiation pneumonitis based on chest x ray were 39,4% that include hazy ground glass opacities, hazy ground glass opacitiesand fibrosis and only fibrosis. There were significant differences between age, radiation doses and history of chemotheraphy with proportion radiation pneumonitis (p<0,05).Conclusion: Proportion radiation pneumonitis based on chest x ray are 39,4%. There are significant differences between age, radiation doses and history of chemotheraphy with proportion radiation pneumonitis (p<0,05)."

"ABSTRAKLatar Belakang: Kanker paru dan tuberkulosis TB adalah dua masalah kesehatan di seluruh dunia dengan angka kesakitan dan kematian yang tinggi. Meningkatnya kasus TB aktif dan reaktivasi TB laten pada pasien kanker paru serta dampak buruknya terhadap prognosis pasien memerlukan upaya untuk melakukan deteksi TB laten pada pasien kanker paru. Penelitian ini bertujuan untuk mengetahui berapa besar proporsi TB laten pada pasien kanker paru, karakteristiknya dan hubungan antar keduanya.Metode: Penelitian ini menggunakan desain potong lintang dan sampel dikumpulkan secara consecutivesampling terhadap 86 pasien kanker paru baru terdiagnosis di Rumah Sakit Umum Pusat Persahabatan Jakarta tahun 2015 hingga 2016. Pemeriksaan sputum Xpert MTB/RIF dilakukan untuk menyingkirkan kemungkinan TB aktif. Penentuan TB laten dilakukan dengan pemeriksaan Interferon Gamma Release Assay IGRA menggunakan alat QuantiFERON-TB Gold-in-Tube QFT-GIT .Hasil: Pemeriksaan TB laten mendapatkan hasil IGRA 11 pasien 12,8 , IGRA - 59 pasien 68,6 dan IGRA indeterminate I 16 pasien 18,6 . Karakteristik sosiodemografi pasien kanker paru dengan TB laten adalah 63,6 laki-laki, rerata usia 56 tahun, 36,4 diimunisasi BCG, 9 dengan kontak erat TB, 72,7 dengan riwayat merokok. Karakteristik klinis pasien tersebut 90 memiliki status gizi normal lebih dengan nilai tengah indeks massa tubuh IMT 19,12 18,24-29,26 kg/m2, nilai tengah hitung limfosit total 1856 1197-4210 sel/ul, 9 dengan komorbid diabetes mellitus, 81,8 tumor paru mengenai lokasi khas predileksi TB paru. Jenis kanker terbanyak adalah adenokarsinoma 81,8 dengan stage lanjut 81,8 dan status tampilan umum 2-3 63,6 . Karakteristik yang menunjukkan hubungan bermakna dengan hasil IGRA adalah lokasi tumor yang mengenai daerah lesi khas TB secara radiologis. Hitung limfosit total yang rendah berhubungan dengan hasil IGRA I dengan nilai tengah 999,88 277-1492,60 sel/ul.Kesimpulan: Proporsi TB laten pada pasien kanker paru di RSUP Persahabatan adalah 12,8 . Karekteristik pasien kanker paru yang berhubungan dengan TB laten adalah lokasi tumor yang mengenai daerah lesi khas TB walaupun belum dapat disimpulkan hubungannya secara biologis. Hasil IGRA I pada pasien kanker paru dengan hitung limfosit total yang rendah menunjukkan keterbatasan sensitivitas IGRA dalam mendeteksi infeksi TB laten pada pasien imunokompromais.Kata Kunci : infeksi TB laten, kanker paru, IGRA, hitung limfosit total

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ABSTRACTBackground Lung cancer and pulmonary tuberculosis TB are two major public health problems associated with significant morbidities and mortalities. The increased prevalence of active TB and latent TB reactivation in lung cancer patients and the negative effect of pulmonary TB in lung cancer prognosis underline the need for a through screening of lung cancer patients for latent TB infection LTBI . The aims of this study are to determine the proportion of LTBI in lung cancer patients, their characteristics and the relationship between them.Methods This study used a cross sectional design and sample was collected using consecutive sampling of the 86 newly diagnosed treatment naive lung cancer patients from a referral respiratory hospital, Rumah Sakit Umum Pusat Persahabatan Jakarta in 2015 to 2016. The presence of LTBI was determined by Quantiferon TB Gold In Tube QFT GIT after having Mycobacterium TB not detected result from Xpert MTB RIF sputum test. Demographic characteristics and cancer related factors associated with LTBI were investigated.Results There are 11 patients 12,8 with IGRA result and 16 patients 18,6 with IGRA indeterminate I result. Sociodemographic characteristics of lung cancer patients with latent TB are 63,6 male, mean of age 56 years, 36,4 with BCG immunization, 9 had TB close contacts history, 72,7 with a history of smoking. The clinical characteristics of these patients are 90 had a normal nutritional status with the median body mass index BMI 19,12 18,24 29,26 kg m2, the median of total lymphocyte count is 1856 1197 4210 cells ul, 9 with diabetes mellitus as comorbid, 81,8 of lung tumour located in the typical predilection for pulmonary tuberculosis. Most types of lung cancer are adenocarcinomas 81.8 with advanced stage 81,8 and the WHO performance status of 2 3 63,6 . Characteristics having significant relationship with IGRA results is the tumour located in the typical TB area radiologically. Low total lymphocyte count is associated with indeterminate IGRA results with median 999,88 277 1492,6 cells ul.Conclusion The proportion of latent TB in lung cancer patients is 12,8 . Characteristics of patients with lung cancer associated with latent TB is the location of the tumor lesions typical of the area although it can not be concluded biologically. Having indeterminate IGRA results in lung cancer patients with a low total lymphocyte count showed the limitations of QFT GIT in detecting latent TB infection in immunocompromised patients.Key words latent TB infection, lung cancer, IGRA, total lymphocyte count "