JURNAL BIOMEDIK (JBM)最新文献

{"title":"Penetrating Facial Injury by a Tree Branch: a Case Report","authors":"M. Tombeng, Eko Prasetyo, Nico Lumintang, M. C. Oley","doi":"10.35790/JBM.11.2.2019.23319","DOIUrl":"https://doi.org/10.35790/JBM.11.2.2019.23319","url":null,"abstract":"Abstrak: Cedera tembus wajah dapat berbahaya karena adanya struktur-struktur penting pada wajah yang membutuhkan penanganan dengan cepat dan tepat. Benda asing organik dapat menyebabkan risiko tinggi infeksi luka. Kami memresentasikan suatu kasus yang jarang ditemukan yaitu seorang laki-laki berusia 19 tahun dengan luka tembus wajah oleh patahan cabang pohon akibat kecelakaan sepeda motor. Panjang cabang pohon 25 cm dengan diameter sekitar 4 cm, menembus melalui sisi depan kanan wajah, tepat di samping hidung, dan menjorok keluar melalui sudut kanan mandibula. Evaluasi dan penatalaksanaan cedera tembus wajah dilakukan mengikuti protokol ATLS. Tujuan penatalaksanaan cedera tembus wajah ialah mengeluarkan benda asing dengan trauma minimal pada struktur berdekatan dan mempertahankan fungsi dan penampilan yang normal. Pasien ini menjalani operasi darurat untuk pengangkatan benda asing dan eksplorasi luka dengan anestesi umum. Evaluasi pasca operasi tidak mendapatkan adanya perdarahan maupun tanda-tanda infeksi. Defisit neurologik pada wajah kanan diterapi secara konservatif dengan terapi fisik dan pulih sepenuhnya satu tahun pasca kecelakaan.Kata kunci: luka tembus, trauma wajah, cabang pohonAbstract: Penetrating facial injury can be dangerous because of the presence of important structures in the face which requires immediate and proper management. Organic foreign bodies may cause a high risk of wound infection. We present a case of a 19-year-old male with an unusual penetrating facial injury by a broken tree branch due to a motorcycle accident. The length of the tree branch was 25 cm with a diameter of approximately 4 cm, penetrating through the right anterior side of his face, just lateral to the nose, and protruding through the right angle of the mandible. The evaluation and management of the penetrating facial injury were performed in accordance with the ATLS protocol. The aim of the penetrating facial injuries management is to remove foreign body with minimal trauma to adjacent structures and to maintain the normal function and appearance. The patient underwent emergency surgery for removal of the foreign body and wound exploration under general anesthesia. In postoperative evaluation, there was not any bleeding or signs of infection. The neurological deficit in the right face was managed conservatively with physical therapy and was fully recovered in 1 year after the accident.Keywords: penetrating wound, facial trauma, tree branch","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"212 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88137824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efek Terapi Oksigen Hiperbarik (TOHB) pada Penyembuhan Ulkus Kaki DM Tipe 2 Berdasarkan Skor PEDIS","authors":"Ekanova R. N. Sumarauw, M. Hatibie, Djony E. Tjandra, F. G. Langi","doi":"10.35790/JBM.11.2.2019.23323","DOIUrl":"https://doi.org/10.35790/JBM.11.2.2019.23323","url":null,"abstract":"Abstract: Diabetic foot ulcer (DFU) is still a health problem related to the extent amount of time in wound healing process hence increasing the treatment cost. Given any methods that are not sat-isfying, encourage the search of other methods that would increase the wound healing rate, in which hyperbaric oxygen therapy (HBOT) is amongst them. The DFU patient that receives HBOT shows a significant increase in angiogenesis process markedly by faster epithelialization and granulation process. This study was aimed to prove that HBOT could accelerate the wound healing process among DFU patients measured by wound size and depth of PEDIS score. This was a ran-domized controlled trial study, conducted at Surgery Department of Prof. Dr. R. D. Kandou Gen-eral Hospital from September 2018 to March 2019. There were 20 DFU patients divided into two groups, each of 10 patients. The control group received a holistic treatment, meanwhile the HBOT group received a holistic treatment added with the inclusion of HBOT. PEDIS score assessment of DFU in HBOT group was measured before and after the third HBOT session, meanwhile the con-trol group was measured on the first and the third day. The results showed that the difference in PEDIS score value was markedly found in HBOT group compared to the control group (2 vs. 0, P=0.001). Conclusion: HBOT could enhance the wound healing process in DFU patients based on the declined PEDIS score.Keywords: HBOT, PEDIS score, diabetic foot ulcerAbstrak: Ulkus kaki diabetik (UKD) masih merupakan masalah kesehatan terkait proses penyembuhan lama sehingga biaya pengobatan meningkat. Belum adanya metode penanganan yang memuaskan, mendorong pencarian metode percepatan penyembuhan luka, salah satunya ialah terapi oksigen hiperbarik (TOHB). Penderita UKD yang menjalani tambahan TOHB diketahui mengalami peningkatan proses angiogenesis yang menghasilkan proses epitelialisasi dan granulasi yang lebih cepat. Tujuan penelitian ialah untuk membuktikan bahwa TOHB dapat mempercepat proses penyembuhan UKD, dinilai berdasarkan ukuran dan kedalaman luka melalui skor PEDIS. Penelitian ini menggunakan randomized controlled trial dan dilaksanakan di Bagian Bedah RSUP Prof. Dr. R.D. Kandou Manado sejak September 2018 sampai dengan Maret 2019. Subyek penelitian sebanyak 20 penderita UKD, dibagi dalam dua kelompok, masing-masing 10 penderita. Kelompok kontrol menjalani penanganan holistik UKD, sedangkan kelompok TOHB menjalani penanganan holistik UKD dengan TOHB. Penilaian skor PEDIS terhadap UKD pada kelompok TOHB dilakukan sebelum dan sesudah TOHB sesi ke-3, sedangkan pada kelompok kontrol dilakukan penilaian pada hari ke-1 dan hari ke-3 sesudahnya. Hasil penelitian mendapatkan bahwa perubahan skor PEDIS yang terjadi antara kedua pengukuran terlihat lebih besar pada kelompok TOHB dibandingkan kelompok kontrol (2 vs 0, P=0,001). Simpulan. TOHB mempercepat proses penyembuhan UKD dinilai dari penurunan skor PEDIS.Kata kunci: TOHB, skor PEDIS, ulkus kaki ","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86200502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korelasi Blood Flow Rate Intraoperasi dan Enam Minggu Pascaoperasi Arteriovenous Fistula Brakiosefalika Dihubungkan dengan Maturitas di RSUP Prof. Dr. R. D. Kandou Manado","authors":"Aubrey W. Palin, Djony E. Tjandra, Richard M. Sumangkut","doi":"10.35790/JBM.11.2.2019.23325","DOIUrl":"https://doi.org/10.35790/JBM.11.2.2019.23325","url":null,"abstract":"Abstract: American National Kidney Foundation (2002) states that end-stage kidney disease is an indication for renal replacement therapy, one of which is hemodialysis. Vascular access comprises a fundamental component of hemodialysis therapy (HD), facilitating the patient’s blood flow to the dialyzer. However, there are some factors affecting the maturity of an arteriovenous fistula (AVF), inter alia the patient, comorbidities, and anatomical and functional conditions of the blood vessels involving the blood flow rate (BFR). This study was aimed to establish the differences between intra-operative BFR and BFR six weeks after surgery as well as any correlations between intraoperative BFR, venous diameter, and skin to vein distance with maturity of brachiocephalic AVF. This was prospective cohort study conducted at the Department of Surgery, Prof. Dr. R. D. Kandou General Hospital Manado. Subjects were 41 CKD patients who underwent brachiocephalic AVF surgery. The vein diameter, skin to vein distance, and BFR were measured immediately as intra-operative data using a Doppler USG and all were re-measured at six-week-follow-up examination as six-week-postoperative data. The results showed that there was a significant increase in BFR at six weeks postoperation compared to intraoperation (t=-19.215; P <0.0001). Bi-serial point correlation analysis revealed that there was a significant correlation between intraoperative venous diameter and maturity (rpb=0.276; P=0.04) as well as a significant correlation between intraoperative BFR and maturity (rpb=0.615; P=0.002). No significant correlation was observed between intra-operative skin to vein distance and maturity (rpb=0.093; P=0.281). Conclusion: There was a significant difference in BFR between intraoperation and 6 weeks postoperation in the mature AV fistula. There was a significant relationship between intraoperative BFR and maturity as well as between intraoperative venous diameter and maturity, while no significant relationship between skin-vein distance and maturity was found.Keywords: brachiocephalic AVF, BFR, maturityAbstrak: American National Kidney Foundation (2002) menyatakan bahwa penderita dengan penyakit ginjal tahap akhir diindikasikan untuk dilakukan terapi pengganti ginjal, salah satunya hemodialisis (HD). Akses vaskular merupakan komponen penting pada terapi HD karena melalui akses vaskular darah dari tubuh pasien dapat dialirkan menuju dialyzer. Terdapat banyak faktor yang memengaruhi maturitas suatu arteriovenous fistula (AVF), yaitu pasien itu sendiri, komorbid, serta keadaan anatomi dan fungsional pembuluh darah termasuk nilai blood flow rate (BFR). Penelitian ini bertujuan untuk mengetahui perbedaan BFR intraoperasi dan BFR enam minggu pascaoperasi serta adanya korelasi antara BFR intraoperasi, diameter vena, dan jarak kulit-vena dengan maturitas AVF brakiosefalika. Penelitian ini dilaksanakan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou Manado dengan desain kohort prospektif. Subyek","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"321 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91308852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hubungan Kadar Interleukin 10 Serum dan Klasifikasi CT Marshall pada Pasien Cedera Otak Berat akibat Trauma","authors":"Melina O. Kurniawan, E. Prasetyo, M. C. Oley","doi":"10.35790/jbm.11.2.2019.23321","DOIUrl":"https://doi.org/10.35790/jbm.11.2.2019.23321","url":null,"abstract":"Abstract: Increased level of interleukin 10 (IL 10) in patients with severe traumatic brain injury (TBI) has been documented, yet studies of its ability to predict the outcome based on the Marshall CT classification are still limited and lacks of clarity. This study was aimed to evaluate the relationship between serum level of IL 10 and the Marshall CT classification among patients with severe TBI. This was an analytical observational single-center study with a cross-sectional design. Immediate CT scans were used to determine the Marshall CT classification and to categorize the location (extra-axial, intra-axial, both), hemisphere (midline/diffuse, dextral, sinistral), and area (frontal, parietal, temporal, occipital, multiple) of the injury. Venous blood sample for IL 10 was taken less than 24 hours of trauma in the Intensive Care Unit. Age and gender were also recorded. Variable selection was run in stepwise forward fashion. Proportional odds models were conducted to assess the changes in the Marshall CT classification related to levels of IL 10. There were 25 patients admitted consecutively to the emergency room (ER) with severe TBI included in this study. The results showed that the mean IL 10 was 107.3 pg/ml (SD 16.2 pg/ml). Patients were distributed almost uniformly within four detected categories (diffuse injury II, III, V, and VI) of the CT Marshall classification. Final regression model consisted of IL 10, age, and injury on temporal area as predictors. Controlling for the others, every 10 pg/ml additional of IL 10 increased the odds to higher (worse) categories in the CT Marshall classification by about 1.95 (95% CI 1.16 – 3.30) times. Conclusion: Interleukin 10 is a potential predictor for the CT Marshall classification in patients with severe TBI.Keywords: IL 10, Marshall CT classification, TBIAbstrak: Peningkatan kadar serum interleukin 10 (IL 10) pada pasien dengan cedera otak traumatik (COT) berat telah didokumentasikan, namun studi tentang kemampuannya untuk memrediksi hasil berdasarkan klasifikasi CT Marshall masih terbatas dan belum jelas. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar serum IL 10 dan klasifikasi CT Marshall pada pasien COT berat. Jenis penelitian ialah observasional analitik dengan desain potong lintang. CT scan digunakan untuk menentukan klasifikasi CT Marshall dan untuk mengategorikan lokasi (ekstra-aksial, intra-aksial, keduanya), hemisfer (garis tengah/ difus, dekstra, sinistra), dan area (frontal, parietal, temporal, oksipital, multipel) otak yang terkena cedera. Sampel darah vena untuk IL 10 diambil kurang dari 24 jam pasca trauma. Usia dan jenis kelamin juga dicatat. Seleksi variabel dilakukan secara bertahap. Digunakan model regresi proporsional odds untuk menilai perubahan klasifikasi CT Marshall terkait dengan kadar IL 10. Hasil penelitian mendapatkan 25 pasien dengan COT berat yang masuk ke Instalasi Rawat Darurat Bedah (IRDB). Rerata IL 10 ialah 107,3 pg/ml (SD 16,2 pg/ml). Pasien","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85129905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Terapi pada Pasien Kanker Payudara Stadium Lanjut Menurunkan Kadar C- Reaktif Protein dan Meningkatkan Kadar Albumin","authors":"Arya Wawolumaja, Victor Pontoh, Marselus A. Merung","doi":"10.35790/JBM.11.2.2019.23324","DOIUrl":"https://doi.org/10.35790/JBM.11.2.2019.23324","url":null,"abstract":"Abstract: Breast cancer is one of the malignancies that has a high prevalence and can occur in both sexes. Albeit, more than 70% of these patients were detected at late stage. Inflammation could accelerate the tumor growth, invasion, angiogenesis, and metastasis. Increased serum CRP indicates uncontrolled infection or pathological process. Meanwhile, serum albumin is used to evaluate the nutrition status, the severity of disease, and prognosis. This study was aimed to evaluate the influence of serum CRP and albumin levels in female patients with breast cancer after treatment. This was an interventional analytical study with a cross sectional design. This study was conducted at Prof. Dr. R. D. Kandou Hosppital Manado. Subjects were all female patients with breast cancer from May to August 2018. The results showed that there were 43 patients of late stage breast cancer, mean age of 52.16 years. After treatment there was a decrease in the mean serum CRP level from 17.05 mg/dL to 6.40 mg/dL and the paired t test obtained a t value of 3.269 and a P value of 0.001. Moreover, there was an increase in the mean serum albumin level from 3.59 mg/L to 3.76 mg/L and the paired t test obtained a t value of -2,896 and a P value of =0.003. Conclusion: Chemotherapy and or surgery performed on female patients with breast cancer could decrease the serum CRP level and increase the serum albumin level.Keywords: breast cancer, serum CRP, serum albuminAbstrak: Kanker payudara merupakan salah satu jenis keganasan yang memiliki prevalensi cukup tinggi dan dapat terjadi baik pada laki-laki maupun perempuan. Lebih dari 70% penderita kanker payudara ditemukan pada stadium lanjut. Keadaan inflamasi dapat mempercepat pertumbuhan tumor, invasi, angiogenesis, dan metastasis. Hadirnya CRP serum yang meningkat mengindikasikan adanya infeksi atau proses patologik yang tidak teratasi. Albumin serum secara umum digunakan untuk menilai status nutrisi, derajat keparahan penyakit, perkembangan penyakit, dan prognosisnya. Penelitian ini bertujuan untuk menilai pengaruh kadar CRP dan albumin serum pada pasien perempuan dengan kanker payudara stadium lanjut setelah terapi. Jenis penelitian ialah intervensional analitik dengan desain potong lintang Penelitian dilakukan di RSUP Prof. Dr. R. D. Kandou Manado. Subjek penelitian ini ialah semua penderita kanker payudara berjenis kelamin perempuan pada periode Mei 2018 s/d Agustus 2018. Hasil penelitian mendapatkan 43 pasien dengan kanker payudara stadium lanjut dengan usia rerata 52,16 tahun. Setelah terapi terjadi penurunan rerata kadar CRP serum dari 17,05 mg/dL menjadi 6,40 mg/dL dan uji t berpasangan menunjukkan nilai t=3,269 dengan P=0,001. Selain itu, terjadi peningkatan rerata kadar albumin serum dari 3,59 mg/L menjadi 3,76 mg/L dan uji t berpasangan menunjukkan nilai t=-2,896 dengan P=0,003. Simpulan: Modalitas kemoterapi dan/atau operasi pada pasien kanker payudara stadium lanjut secara bermankna menurunkan kadar CRP serum tetapi meni","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81301906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pola Luka pada Kasus Kecelakaan Lalu Lintas di Bagian Ilmu Kedokteran Forensik dan Medikolegal RSUP Prof. Dr. R. D. Kandou Manado Periode Tahun 2017","authors":"Felicia R. Kepel, Johannis F. Mallo","doi":"10.35790/JBM.11.1.2019.23207","DOIUrl":"https://doi.org/10.35790/JBM.11.1.2019.23207","url":null,"abstract":"Abstract: Traffic accident is one of the main cause of death in Indonesia. In 2013 across South East Asia, Indonesia was the first rank with 26,416 traffic accidents. Accidents that occur can cause injuries from the minor injuries, disability, and even death. Every case of a traffic accident has a different pattern of injury. This study was aimed to obtain the pattern of injuries due to traffic accident based on gender, age, victim’s role before the occurence of a traffic accident, injury type, and wound location. This was a descriptive retrospective study using data of postmortem report (visum et repertum) of the traffic accidents victims. The results showed that majority of the traffic accident victims were 26-35 years (21.05%). Males were more common than females (78.9% vs 21.1%). Most of victim roles was as motorcyclist (78.95%). The most common type of wounds among traffic accident victims was blister mainly located on the extremity, meanwhile in car passangers, the most common type of wound was bruise mainly located on the head. Conclusion: The majority of trafic accident victims were males aged 26-35 years. Most wounds were blister in the extremity followed by bruise on the head.Keywords: pattern of wounds, traffic accident casesAbstrak: Kecelakaan lalu lintas (KLL) merupakan salah satu penyebab kematian terbesar di Indonesia. Pada tahun 2013 dalam tingkatan Asia Tenggara, Indonesia menduduki peringkat pertama dengan 26.416 jumlah kejadian KLL. Kecelakaan yang terjadi dapat menyebabkan luka-luka dari luka ringan hingga terjadinya kecacatan pada korban bahkan yang paling fatal dapat menyebabkan kematian. Setiap kasus kecelakaan lalu lintas menyebabkan adanya ada suatu pola luka yang berbeda-beda. Penelitian ini bertujuan untuk mendapatkan pola luka pada kasus KLL berdasarkan jenis kelamin, usia, peran korban sebelum terjadi KLL, jenis luka, dan lokasi luka. Jenis penelitian ialah deskriptif retrospektif dengan menggunakan data sekunder yang diambil dari visum et repertum (VeR) korban kecelakaan lalu lintas. Hasil penelitian mendapatkan mayoritas korban KLL berusia 26-35 tahun (21,05%). Korban berjenis kelamin laki-laki lebih banyak daripada perempuan (78,9% vs 21,1%). Peran korban KLL terbanyak ialah pengemudi sepeda motor (78,95%). Pola luka terbanyak pada korban KLL baik penge-mudi sepeda motor, yang dibonceng, dan pejalan kaki ialah luka lecet terutama di ekstremitas, sedangkan pada penumpang mobil ialah luka memar terutama di kepala. Simpulan: Mayoritas KLL ialah laki-laki usia 26-35 tahun dengan pola luka terbanyak ialah luka lecet di ekstremitas diikuti oleh luka memar di kepala.Kata kunci: pola luka, kasus kecelakaan lalu lintas","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76653064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penggunaan CONUT Score sebagai Prediktor Komplikasi Pasca Pem-bedahan Kanker Kolorektal di RSUP Prof. Dr. R. D. Kandou Manado","authors":"Hendry Sundah, Toar Mambu, Ferdinand Tjandra, Heber B. Sapan, Winfrid M. Sumanti","doi":"10.35790/JBM.11.1.2019.23212","DOIUrl":"https://doi.org/10.35790/JBM.11.1.2019.23212","url":null,"abstract":"Abstract: Nutritional status is one of the factors that influence the metabolic and physiological conditions. Cancer patients, especially colorectal cancer (CRCA), will suffer from decreased nutritional status during their sickness. CONUT score is beneficial to evaluate the nutritional and immunity status of the patients and has been proved to correlate with post operative complications and length of stay. This study was aimed to evaluate the relationship between CONUT score and postoperative complications in CRCA patients. This was an analytical observational study with a cross sectional design. Subjects were 38 patients of CRCA that underwent operation and were admitted at Surgery Inpatients Installation of Prof. Dr. R. D. Kandou Hospital Manado. The result of logistic regression analysis indicated that there was a significant correlation between CONUT score and the risk of complication. The higher the CONUT score, the higher the risk of complication. The determination of complication diagnostic value based on CONUT score was obtained by using ROC curve. The ROC analysis showed that the AUC of CONUT score was 0.977 >0.700 and the cutoff point of CONUT score was 5.5. Patients with CONUT score >5.50 had a tendency to get postoperative complications with the sensitivity of 86.6%, specifity of 95.6%, and accuracy of 94.74%. Conclusion: CONUT score can be used as a screening method to predict the occurence of postoperative complications in CRCA patients.Kata kunci: colorectal cancer, CONUT score, postoperative complicationsAbstrak: Salah satu faktor yang memengaruhi keadaan metabolik dan fisiologik ialah status nutrisi. Penderita kanker terlebih kanker kolorektal (KKR) akan mengalami pengurangan nutrisi selama perjalanan penyakit. CONUT score bermanfaat untuk mengevaluasi status gizi dan imunitas pasien serta terbukti berkolerasi dengan komplikasi serta jumlah hari rawat di rumah sakit pasca pembedahan. Penelitian ini bertujuan untuk mengetahui hubungan CONUT score dengan komplikasi pasca pembedahan KKR. Jenis penelitian ialah analitik obser-vasional dengan desain potong lintang. Subyek penelitian ialah 38 pasien KKR yang menjalani operasi dirawat di Instalasi Rawat Inap Bedah RSUP Prof. Dr. R. D. Kandou Manado. Hasil analisis regresi logistik menyatakan terdapat hubungan yang sangat bermakna antara CONUT score dan kejadian komplikasi. Hubungan ini menyatakan bahwa makin tinggi CONUT score makin besar risiko terjadinya komplikasi. Penentuan nilai diagnostik kom-plikasi berdasarkan CONUT score diperoleh melalui kurva ROC. Berdasarkan analisis ROC diperoleh AUC CONUT score 0,977 >0,700. Hasil analisis ROC memperoleh titik potong CONUT score = 5,5. Pasien dengan CONUT score >5,50 memiliki kecenderungan mengalami komplikasi dengan sensitivitas 86,6%, spesifitas 95,6%, dan nilai akurasi 94,74%. Simpulan: CONUT score dapat digunakan sebagai metode skrining untuk memrediksi terjadinya komplikasi pasca pembedahan kanker kolorektal.Kata kunci: karsinoma kolo","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83948091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pemeriksaan Laboratorium sebagai Indikator Sepsis dan Syok Septik","authors":"D. Purwanto, Dalima A. W. Astrawinata","doi":"10.35790/JBM.11.1.2019.23204","DOIUrl":"https://doi.org/10.35790/JBM.11.1.2019.23204","url":null,"abstract":"Abstract: The complexity of the pathogenesis and pathophysiology of sepsis involves almost all types of cells, tissues, and organ systems. Therefore, there are numbers of laboratory tests that can be used as biomarkers of sepsis and septic shock. Some widely used biomarkers are divided into groups of bacterial products, acute phase proteins, tissue hypoperfusion, coagulation mediators, cell surfaces, and cytokines.Keywords: sepsis, septic shock, biomarkersAbstrak: Kompleksnya patogenesis dan patofisiologi sepsis melibatkan hampir semua jenis sel, jaringan, dan sistem organ. Oleh karena itu, terdapat banyak parameter laboratorik yang dapat dijadikan biomarker sepsis dan syok septik. Berbagai biomarker yang banyak digunakan terbagi dalam kelompokan produk bakteri, protein fase akut, hipoperfusi jaringan, mediator koagulasi, permukaan sel, dan sitokin.Kata kunci: sepsis, syok septik, biomarker","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75496455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kadar Bilirubin, Alkalin Fosfatase, dan Gamma Glutamil Transpeptidase Serum sebagai Prediktor Batu Duktus Koledokus pada Pasien Batu Empedu Simtomatik","authors":"Maria Kaunang, Jimmy Panelewen, Toar Mambu","doi":"10.35790/JBM.11.1.2019.23209","DOIUrl":"https://doi.org/10.35790/JBM.11.1.2019.23209","url":null,"abstract":"Abstract: Complications of the common bile duct stone occur in 10-15% of patients with gallstones. Bilirubin, alkaline phosphatase (ALP), and gamma glutamyl transpeptidase (GGT) are routine laboratory tests performed on patients with gallstones. This study was aimed to determine whether bilirubin, ALP, and GGT serum could be used as predictors of common bile duct stone in patient with symptomatic gallstone at Prof. Dr. R. D. Kandou Hospital Manado and its satellite hospitals. This was a prospective analytical observational study with a cross sectional design. Subjects were 38 patients with symptomatic gallstone that underwent definitive surgery. The bilirubin, ALP, and GGT serum levels were taken at presentation. Receiver operating character-istic curve analysis was used to determine optimal biochemical cut-off value of each parameter. The results showed that of 38 patients, 22 patients were male and 16 patients were female. The mean ages were 52 years in males and 47 years in females. There were 28 patients proven to have stones in common bile ducts. All parameters were proven to be effective in predicting common bile duct stone, as follows: bilirubin cut-off point was 1.6 U/L with sensitivity of 96.4% and specifity of 90%; ALP cut-off point was 114 U/L with sensitivity of 82.1% and specifity of 90%; and GGT cut-off point was 102.5 U/L with sensitivity of 85.7% and specifity of 90%. Conclusion: Bilirubin, ALP, and GGT serum levels can be used as predictors of common bile duct stone in patient with symptomatic gallstone.Keywords: bilirubin, ALP, GGT, common bile duct stoneAbstrak: Komplikasi batu duktus koledokus terjadi pada 10-15% pasien dengan batu empedu. Bilirubin, alkalin fosfatase (ALP), and gamma glutamil transpeptidase (GGT) merupakan pemerik-saan laboratorium rutin pada pasien dengan batu empedu. Penelitian ini bertujuan untuk menentukan apakah bilirubin, ALP, dan GGT serum dapat dipakai sebagai prediktor batu duktus koledokus pada pasien dengan batu empedu simtomatik di RSUP Prof. Dr. R. D. Kandou Manado dan rumah sakit jejaringnya. Jenis penelitian ialah observasional analitik prospektif dengan desain potong lintang. Pemeriksaan kadar bilirubin, ALP, dan GGT serum dilakukan pada semua subyek saat didiagnosis batu empedu simtomatik. Receiver operating characteristic curve analysis diguna-kan untuk menentukan nilai titik potong biokimia yang optimal dari setiap parameter. Hasil penelitian mendapatkan sebanyak 38 pasien dengan batu empedu simtomatik yang menjalani operasi definitif, terdiri dari 22 pasien laki-laki and 16 pasien perempuan. Rerata usia subyek ialah 52 tahun pada laki-laki dan 47 tahun pada perempuan. Terdapat 28 pasien terbukti dengan batu duktus koledokus. Semua parameter terbukti efektif dalam memrediksi batu doktus koledokus sebagai berikut: titik potong bilirubin serum 1,6 U/L dengan sensitivitas 96,4% and spesifitas 90%; titik potong ALP serum 114 U/L dengan sensitivitas 82,1% dan spesifitas 90%; titik potong GGT ser","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77322338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrofil Darah Tepi pada Pasien Kanker Payudara Stadium Lanjut Sebelum dan Sesudah Dilakukan Tindakan","authors":"Rizky Asri, Victor Pontoh, Marselus A. Merung","doi":"10.35790/JBM.11.1.2019.23213","DOIUrl":"https://doi.org/10.35790/JBM.11.1.2019.23213","url":null,"abstract":"Abstract: Worldwide, there were around 2.1 million breast cancer cases diagnosed in 2018. There was nearly 1 of 4 cancer cases among women with an incidence of 38,1 per 100.000 and mortality of 14,1 per 100.000. This study was aimed to determine whether there was a change in response score of systemic inflammation by using peripheral blood neutrophil level in female patients with advanced stage of breast cancer before and after treatment. This was an interventional analytical study with a cross sectional design, conducted at Prof. Dr. R. D. Kandou Hospital Manado. The results showed that there were 43 patients in the period of May 2018 to August 2018. The youngest age was 34 years and the oldest age was 70 years with a mean of 52.16 years (SD±10.002). The most frequent stage was III B (58.1%), followed by IIIC (25.6%), IIIA (11.6%), and IV (4.7%). Before treatment, the highest level of neutrophil was 55%, the lowest level was 12%, with a mean of 27.84% (SD±10.005). After treatment, the highest level of neutrophil was 45%, the lowest level was 11%, with a mean of 22.7% (SD±6.635). The paired-t test showed a very significant difference in peripheral blood neutrophil level between before and after treatment (P<0.001). Conclusion: There was a significant decrease of peripheral blood neutrophil level in breast cancer patients after treatment.Keywords: plasma neutrophil, advanced stage of breast cancerAbstrak: Di seluruh dunia, terdapat sekitar 2,1 juta kasus kanker payudara wanita yang didiagnosis pada tahun 2018, serta terhitung hampir 1 dari 4 kasus kanker di kalangan wanita dengan insidensi 38,1 per 100.000 dan kematian sebanyak 14,1 per 100.000. Penelitian ini bertujuan untuk untuk menilai adanya perubahan skor respons peradangan sistemik dengan menggunakan kadar neutrofil darah tepi pada pasien kanker payudara stadium lanjut sebelum dan setelah terapi. Jenis penelitian ialah intervensional analitik dengan desain potong lintang, yang dilakukan di RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian mendapatkan 43 pasien sejak Mei 2018 s/d Agustus 2018. Usia termuda 34 tahun dan usia tertua 70 tahun dengan rerata usia 52,16 tahun (SD±10,002). Stadium terbanyak ialah stadium IIIB (58,1%), diikuti stadium IIIC (25,6%), stadium IIIA (11,6%), dan stadium IV (4,7%). Sebelum dilakukan tindakan didapatkan kadar neutrofil tertinggi 55%, kadar terendah 12%, dan rerata 27,84% (SD±10,005). Setelah dilakukan tindakan didapatkan kadar neutrofil tertinggi 45%, terendah 11%, dan rerata 22,7% (SD±6,635). Hasil uji t berpasangan mendapatkan perbedaan yang sangat bermakna dari kadar neutrofil sebelum dan sesudah terapi (P<0,001). Simpulan: Terdapat penurunan bermakna dari kadar neutrofil darah tepi pada pasien kanker payudara setelah dilakukan tindakan.Kata kunci: neutrofil darah tepi, kanker payudara stadium lanjut","PeriodicalId":17726,"journal":{"name":"JURNAL BIOMEDIK (JBM)","volume":"298 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78326476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}