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

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

"Latar Belakang. Perkembangan teknologi dan meningkatnya peran penggunaan tangan di bidang industri, rumah tangga dan perkantoran akan meningkatkan angka kejadian STK. Hal ini akan memiliki dampak negatif di bidang medis, sosial dan ekonomi. Pemeriksaan Ultrasonografi (USG) berguna sebagai penunjang dalam mendiagnosis STK. Kemajuan dalam kualitas dan portabilitas USG telah menempatkan USG sebagai alat pilihan dalam penelitian dan penerapan klinis di bidang neurologi. USG mudah dijumpai di pelayanan kesehatan, memiliki biaya yang murah, waktu pemeriksaan yang singkat dan tidak invasif, serta memiliki sensitivitas dan spesifisitas yang cukup baik dalam mendiagnosis STK. Metode. Desain penelitian berupa studi potong lintang. Subyek penelitian adalah pasien Poliklinik Neurologi RSCM yang memenuhi kriteria inklusi dan eksklusi. Subyek diperoleh secara konsekutif. Pada subyek dilakukan wawancara, pengisian kuesioner, pemeriksan fisik, elektroneurografi dan ultrasonografi di Poliklinik Neurologi RSCM. Dilakukan analisis data menggunakan perangkat SPSS 17.0. Hasil. Diperoleh 58 subyek tangan yang masuk kriteria inklusi. Sensitivitas dan spesifisitas kombinasi gambaran klinis dan USG adalah 86,04% dan 73,33%. Sedangkan akurasi kombinasi gambaran klinis dan USG sebesar 82,75%. Terdapat kesesuaian antara pemeriksaan kombinasi klinis dan USG dengan kombinasi klinis dan elektroneurografi dalam mendeteksi STK (kappa = 0,70). Kesimpulan. Nilai sensitivitas kombinasi gambaran klinis dan USG sama dengan elektroneurografi. Sedangkan spesifisitas kombinasi gambaran klinis dan USG lebih rendah daripada elektroneurografi. Kombinasi gambaran klinis dan USG dapat digunakan sebagai alternatif pemeriksan dalam mendiagnosis STK.

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Background. Technological development and the increased use of hands in the fields of industrial, household and office space will increase the prevalence of Carpal Tunnel Syndrome (CTS). This will have a negative impact on medical science, social and economic. Ultrasonography (USG) is useful to support diagnosis of CTS. Progress in the quality and portability of ultrasound has placed ultrasound as a chosen instrument in research and clinical application in the field of neurology. USG is easily found at the health centers, has a lower cost, a short examination time and not invasive, as well as having superior specificity and sensitivity is good enough in diagnosing CTS.

Method. A cross-sectional sectional study was conducted. The research subject were patients of the Neurology Clinic of RSCM Hospital who meet all of the inclusion and exclusion criteria.

Result. Fifthy eight hands were included in this study. The sensitivity and specificity of the combination of clinical features and ultrasonography were 86.04% and 73.33%. While, the accuracy of the combination of clinical features and ultrasonography was 82.75%. There is a conformity between the combination of clinical features and ultrasound with a combination of clinical picture and electroneurography in diagnosing CTS (kappa = 0.70).

Conclusion. The combination of clinical features and ultrasonography has similar sensitivity with electroneurography. Meanwhile, the specificity of the combination of clinical features and ultrasonography is inferior to electroneurography. Thus, the combination of clinical features and ultrasonography can be used as an alternative to electroneurography in diagnosing CTS."