Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Metastatic Bone Disease (MBD) merupakan tempat penyebaran jauh terbanyak ketiga setelah paru dan liver. Hal ini menimbulkan morbiditas yang tidak sedikit dan pada akhirnya memengaruhi kualitas hidup dan kesintasan pasien. Penelitian ini menggunakan studi potong lintang di RSUPN Cipto Mangunkusumo dengan total sampling. Pasien yang terdiagnosis MBD selama periode 2008 - 2018 dilihat karakteristik, kesintasan, dan jika masih hidup, dilakukan penghitungan skor fungsional menggunakan kuesioner SF-36 dan MSTS. Terdapat 113 pasien MBD dengan rerata usia 54,34 ± 11,09, 69% perempuan, 24,8% tumor primer dari paru, 17,7% dari mammae, 16,8% dari tiroid. 55,8% lesi MBD terdapat pada ekstremitas dan 74,3% merupakan lesi soliter. 65,5% pasien tidak menjalani operasi, namun 78,8% mendapatkan bisfosfonat dan 51,3% mendapatkan radioterapi. Sebanyak 82,3% pasien sudah meninggal, sehingga terdapat 20 pasien yang masih hidup. SF-36 menunjukkan rentang median 40,0 - 100,0 dari 8 skala yang ada. MSTS ekstremitas atas rerata 45,55 ± 24,46 dan ekstremitas bawah median 26,67 (20,00 - 60,00). Analisis bivariat menunjukkan hubungan antara pembedahan dengan kesintasan (P=0,034). Analisis multivariat menunjukkan operasi memiliki peluang terhadap kesintasan yang lebih baik sebesar 2,8 kali (95%CI 1,1 - 7,6). Operasi memiliki hubungan yang bermakna terhadap kesintasan pasien MBD. ......Metastatic Bone Disease (MBD) is the third distant sites after lungs and liver. This creates morbidity and affect patient s quality of life and survival. This study uses cross sectional design with total sampling at one tertiary referral center. MBD patient during 2008 - 2018 were evaluated for characteristics, treatment received, and survival rate. Survived patients were evaluated for functional score with SF-36 and MSTS. From 113 patients, with mean age of 54,34 ± 11,09, 69% were female, 24,8% were lung primary tumor, 17,7% from breast tumor, and 16,8% from thyroid tumor. 55,8% of the lesions were from extremity and 74,3% were solitary lesions. 65,5% patients did not get a surgery, 78,8% were given bisphosphonates, and 51,3% got a radiotherapy treatment. 82,3% patients were already died, so we got 20 patients that were still alive and being evaluated for the functional score. SF-36 shows median of 40,0 - 100,0 from 8 scales, and upper extremity MSTS results mean 45,55 ± 24,46, and lower extremity MSTS results median 26,67 (20,00 - 60,00). Bivariate analysis shows statistically significant association of surgery with survival (P=0,034). Multivariate analysis shows surgery has a 2,8 times higher chance of survival (95%CI 1,1 - 7,6). Surgery has a significant association with MBD patient survival.

Abstrak :
Pendahuluan: Metastatic Bone Disease (MBD) merupakan tempat penyebaran jauh terbanyak ketiga setelah paru dan liver. Hal ini menimbulkan morbiditas yang tidak sedikit dan pada akhirnya memengaruhi kualitas hidup dan kesintasan pasien. Metode: Penelitian ini menggunakan studi potong lintang di RSUPN Cipto Mangunkusumo dengan total sampling. Pasien yang terdiagnosis MBD selama periode 2008 – 2018 dilihat karakteristik, kesintasan, dan jika masih hidup, dilakukan penghitungan skor fungsional menggunakan kuesioner SF-36 dan MSTS. Hasil: Terdapat 113 pasien MBD dengan rerata usia 54,34 ± 11,09, 69% perempuan, 24,8% tumor primer dari paru, 17,7% dari mammae, 16,8% dari tiroid. 55,8% lesi MBD terdapat pada ekstremitas dan 74,3% merupakan lesi soliter. 65,5% pasien tidak menjalani operasi, namun 78,8% mendapatkan bisfosfonat dan 51,3% mendapatkan radioterapi. Sebanyak 82,3% pasien sudah meninggal, sehingga terdapat 20 pasien yang masih hidup. SF-36 menunjukkan rentang median 40,0 – 100,0 dari 8 skala yang ada. MSTS ekstremitas atas rerata 45,55 ± 24,46 dan ekstremitas bawah median 26,67 (20,00 – 60,00). Analisis bivariat menunjukkan hubungan antara pembedahan dengan kesintasan (P=0,034). Analisis multivariat menunjukkan operasi memiliki peluang terhadap kesintasan yang lebih baik sebesar 2,8 kali (95%CI 1,1 – 7,6). Kesimpulan: Operasi memiliki hubungan yang bermakna terhadap kesintasan pasien MBD. ......Introduction: Metastatic Bone Disease (MBD) is the third distant sites after lungs and liver. This creates quite morbidity and in the end affect the patient’s quality of life and survival. Methods: This study uses cross sectional design with total sampling at Cipto Mangunkusumo Hospital. MBD diagnosed patient during 2008 – 2018 were evaluated for characteristics, survival rate. Survived patient will evaluated for functional score with SF-36 and MSTS. Results: From 113 patients, with mean age of 54,34 ± 11,09, 69% were female, 24,8% were lung primary tumor, 17,7% from breast tumor, and 16,8% from thyroid tumor. 55,8% of the lesions were from extremity and 74,3% were solitary lesions. 65,5% patients did not get a surgery, 78,8% were given bisphosphonates, and 51,3% got a radiotherapy treatment. 82,3% patients were already died, so we got 20 patients that were still alive and being evaluated for the functional score. SF-36 shows median of 40,0 – 100,0 from 8 scales, and upper extremity MSTS results mean 45,55 ± 24,46, and lower extremity MSTS results median 26,67 (20,00 – 60,00). Bivariate analysis shows statistically significant association of surgery with survival (P=0,034). Multivariate analysis shows surgery has a 2,8 times higher chance of survival (95%CI 1,1 – 7,6). Conclusion: Surgery has a significant association with MBD patient survival.

Abstrak :
LATAR BELAKANG Pembedahan merupakan pengobatan utama tumor spinal pada umumnya. Pembedahan minimal invasif menjadi trend karena menghasilkan cidera jaringan minimal dengan tujuan operasi tetap tercapai. Laminektomi unilateral merupakan salah satu teknik yang memenuhi pilar dasar operasi minimal invasif. Penulis mengevaluasi efektivitas dan efisiensi teknik laminektomi unilateral removal tumor serta perbandingan terhadap teknik konvensional. METODE Disain studi deskriptif analitik dengan data rekam medis periode Januari 2015 – Juni 2020. Skor fungsional (VAS, KPS, Recovery rate/Hirabayashi, Nurick) dihitung saat pra dan pascaoperasi 1, 3, 6, 12, dan 24 bulan. Efisiensi teknik laminektomi unilateral dievaluasi melalui lama operasi, jumlah perdarahan, lama rawat. Efektivitas dievaluasi melalui resektabiltas intraoperasi dan MRI kontrol tulang belakang pasca operasi HASIL Terdapat 26 pasien, rerata usia (44.17 ± 14.4) tahun, lelaki 12 (46.1%) dan perempuan 14 (53.8%). Skor fungsional pra operasi (Median VAS 4 (0-8), Nurick 4.5 (1-6), JOA servikal 5 (2-10), Torakal 3.5 (2-9), lumbal 19 (14-23) dan KPS 60 (40-80). Follow up 24 bulan pascaoperasi VAS (0) 94%, recovery rate excellent 81%, Nurick (< 3) 87% dan KPS (> 70%) 87%. Median perdarahan intraoperasi 175 (50-1200) ml, lama operasi 180 (120-540) menit dan lama rawat 6.5 (4-42) hari. Gross total resection 76.9%. Terdapat satu komplikasi pseudomeningocele pada follow up 3 bulan pascaoperasi yang menghilang tanpa intervensi pada follow up MRI kontrol 6 bulan pascaoperasi. SIMPULAN Laminektomi unilateral memungkinkan gross total resection dengan recovery rate baik, trauma operasi dan komplikasi lebih kecil terhadap teknik konvensional. ......BACKGROUND Pembedahan merupakan pengobatan utama tumor spinal pada umumnya. Pembedahan minimal invasif menjadi trend karena menghasilkan cidera jaringan minimal dengan tujuan operasi tetap tercapai. Laminektomi unilateral merupakan salah satu teknik yang memenuhi pilar dasar operasi minimal invasif. Penulis mengevaluasi efektivitas dan efisiensi teknik laminektomi unilateral removal tumor serta perbandingan terhadap teknik konvensional. METHOD Design of study is analytic descriptive using medical records period January 2015 – June 2020. Functional Scores (VAS, KPS, Recovery rate/Hirabayashi, Nurick) achieved pre and postoperation 1,3,6,12,and 24 months. Efficiency is observed from operative time, intraoperative bleeding, length of stay. Effectivity is observed from resectability during intraoperative and MRI control post operation. RESULT There are 26 patients, mean age ( 44.17 ± 14.4) years, male 12 (46.1%), female 14 (53.8%). Functional score pre operation (median VAS 4 (0-8), Nurick 4.5 (1-6), JOA cervical 5 (2-10), Thoracal 3.5 (2-9), lumbar 19 (14-23) and KPS 60 (40-80). At Follow up 24 months after operation there are 94% with no pain, 81% excellent recovery rate, 87% Nurick <3 and 87% KPS >70%. Median of estimated blood loss 175 (50-1200) ml, operative time 180 (120-540) min and length of stay 6.5 (4-42) days. Gross total resection are 20 (76.9)% cases. There are one complication pseudomeningocele which detected in MRI control after 3 month surgery, then resolved without surgery by the 6 months control. CONCLUSION Gross total resection maybe achieved by unilateral laminectomy and produces less complication and trauma compare to conventional technique.

Abstrak :
ABSTRAK
Background: obesity and osteoarthritis have strong inter-relationship with multi-factorial mechanism that caused pain and leads to decreased quality of life. Exercise has been identified as prevention and management against obesity and joint pain. This systematic review aims to assess the effect between exercises compared to diet group for chronic pain management, physical and mental function in obese patients with chronic musculoskeletal problem. Methods: we performed a systematic search of Randomized Control Trial studies from Cochrane CentralRegister of Controlled Trials (CENTRAL); MEDLINE; EBSCO; SCIENCEDIRECT (Elsevier); SCOPUS, grey literature, trial registry, ongoing study for published studies, and from the ClinicalTrial.gov, thesis of rehabilitation medicine in RSCM, and proceeding books for unpublished studies that was last updated on November 2016. Risk of bias was assessed using Cochrane risk-of-bias tool and data were analyzed using Review Manager 2014. Results: one study showed no difference in pain reduction (assessed using VAS) between two groups. Two studies showed improvement in physical function measured using 6MWT in exercise group at 6 and 18 months with mean difference 28.12 [11.20, 45.04] and 26.21 [9.01, 43.41]. There was no significant effects observed for Mental and Physical Function based on SF-36 after 6 months (1 study) and 18 months (2 studies) observation, with mean difference 1.10 [-0.79, 2.99] and 0.08 [-1.53, 1.70] respectively for Mental Function score and -0.30 [-2.54, 1.94] and -0.36 [-2.30, 1.57] respectively for Physical Function score. Conclusion: exercise can improve physical function objectively, but could not reduce pain in obese patients with chronic musculoskeletal problem subjectively. Keywords: exercises intervention, chronic pain management, functional score, quality of life, systematic review.