Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar Belakang: kematian dan kecacatan diseluruh dunia dan mempunyai dampak yang sangat besar baik dari segi klinis maupun sosio-ekonomi. Pada stroke iskemik akut, terdapat peningkatan kadar IL-6 yang berkorelasi dengan defisit neurologis yang lebih berat, kerusakan otak yang lebih luas dan prognosis yang lebih buruk.Oleh karena itu IL-6 dapat digunakan sebagai pemeriksaan biomarker awal untuk identifikasi pasien stroke akut yang memiliki risiko tinggi mengalami progresifitas defisit neurologis dan tingkat kematian yang lebih tinggi. Tujuan: Untuk mengetahui hubungan kadar interleukin 6 dengan keluaran klinis jangka panjang menggunakan mRS (Modified Rankin Scale) pada pasien stroke iskemik akut. Metode: Penelitian dilakukan menggunakan disain penelitian retrospective cohort, melanjutkan dari penelitian Al Rasyid. Semua sampel yang didapatkan di RS Cipto Mangunkusumo Jakarta, dari bulan Februari 2013 sampai selesai dilakukan follow up dilakukan pemeriksaan interleukin 6 serta penilaian keluaran fungsional mRS 3 bulan dan 6 bulan. Hasil: Data sekunder yang berjumlah 135 subjek, diambil secara simple random sampling sebanyak 50 subjek. Masing-masing 25 subjek untuk kelompok interleukin 6 normal dan 25 subjek untuk kelompok interleukin 6 tinggi lalu dilakukan penilaian mRS 1 bulan dan 3 bulan. Hasil penelitian menunjukkan pada kedua kelompok IL-6 tidak memiliki perbedaan yang bermakna terhadap mRS 1 bulan dan 3 bulan (p= 0.244; p=0.155). Namun penelitian ini menunjukkan terdapat hubungan yang bermakna pada kelompok penelitian IL-6 normal dan tinggi dengan perubahan nilai mRS 1 bulan ke mRS 3 bulan (p=0.012; p=0.021) dengan perubahan nilai mRS yang membaik menunjukkan proporsi yang lebih besar. Faktor risiko stroke lain seperti hipertensi, penyakit jantung, DM, dislipidemia dan merokok tidak menunjukkan adanya hubungan yang bermakna dengan perubahan nilai mRS (p=0.377; p=0.285; p=0.736; p=0.222; p=0.736). Simpulan: Penelitian saat ini menunjukkan pada pasien stroke iskemik akut sirkulasi parsial anterior, tidak didapatkan hubungan langsung yang bermakna antara keluaran fungsional stroke fase akut berdasarkan mRS 1 dan 3 bulan dengan kadar IL-6 namun terdapat hubungan yang bermakna antara perubahan nilai mRS dengan IL-6 yang menandakan terdapat kecenderungan bahwa keluaran mRS buruk 1 dan 3 bulan dipengaruhi IL-6. Secara umum terdapat kecenderungan keluaran mRS buruk saat 1 maupun 3 bulan pada subjek dengan IL-6 tinggi.

---

Background: Stroke is one of the leading diseases that causes death and disability throughout the world. In acute ischemic stroke, there is an increase in IL-6 levels were correlated with more severe neurological deficit, brain damage is more extensive and a worse prognosis. Therefore, IL-6 can be used as an early biomarker screening for the identification of acute ischemic stroke patients who have a high risk of progression of neurological deficits and higher mortality rates.

Objective: To determine the relationship of interleukin 6 with functional outcome using mRS (modified rankin scale) in patients with acute ischemic stroke.

Methods: The study was conducted using a retrospective cohort study design, this study is a part of main study from Al Rashid research. All samples were obtained at Cipto Mangunkusumo, from February 2013 until complete follow-up. Interleukin 6 examination performed in all samples as well as evaluating the functional outcome based on mRS 3 months and 6 months.

Results: Secondary data totaling 135 subjects, drawn by simple random sampling of 50 subjects. Each group of 25 subjects for high IL-6 and 25 normal IL-6 subjects were assesed with mRS 1 month and 3 months. The results showed in both groups that IL‐6 does not have a significant difference in mRS 1 month and 3 months (p = 0.244, p = 0.155). However, this study shows there is a significant correlation between IL‐6 changes in mRS score mRS 1 month to 3 months (p = 0.012, p = 0.021) with changes that improved mRS score indicates a greater proportion. Other stroke risk factors such as hypertension, heart disease, diabetes, dyslipidemia, and smoking did not show any significant correlation with changes in mRS score (p = 0.377, p = 0.285, p = 0736, p = 0.222, p = 0736).

Conclusions: The present study showed in patients with acute ischemic stroke partial anterior circulation there is no significant direct relationship found between the acute phase of stroke functional outcome based on mRS 1 and 3 months with the levels of IL‐6 but there is a significant correlation between changes in mRS score with IL-6 indicates there is a tendency that poor mRS outcomes 1 and 3 months influenced by IL‐6. In general there is a tendency of poor outcomes pf mRS 1 and 3 months in subjects with high IL‐6. "

"Latar Belakang. Stroke iskemik dan gagal jantung merupakan masalah kesehatan utama di dunia. Keduanya memiliki faktor risiko yang sama sehingga sering muncul bersamaan sebagai komorbid. Keduanya juga dikaitkan dengan gangguan viskositas darah dan luaran fungsional yang lebih buruk. Penelitian ini bertujuan untuk menilai perbandingan nilai viskositas darah dan luaran fungsional pasien stroke iskemik subakut dan kronis dengan dan tanpa komorbid gagal jantug.Metode. Penelitian ini menggunakan desian case control yang dilakukan di klinik rawat jalan Neurologi RSUPN dr. Cipto Mangunkusumo pada bulan Maret dan April 2023. Analisis univariat, bivariat dan multivariat dilakukan sesuai kebutuhan.Hasil. Penelitian ini melibatkan 24 pasien stroke iskemik subakut dan kronis dengan komorbid gagal jantung dan 24 pasien stroke iskemik subakut dan kronis tanpa komorbid gagal jantung. Tidak didapatkan perbedaan rerata pada semua variabel penelitian yang terdiri dari nilai viskositas darah (5,45±0.77poise vs 5,50±0,77poise, p = 0,85); nilai viskositas plasma (1,78±0,31poise vs 1,80±0,32poise, p = 0,87); kadar hematokrit (38,42±4,78% vs 40,43±4,25%, p = 0,13); kadar fibrinogen (401,03±121,18mg/dL vs 346,49±70,07mg/dL); dan nilai mRS (2(0-4) vs 1(0-3), p = 0,37).Kesimpulan. Tidak ada perbedaan rerata nilai viskositas darah, viskostias plasma, kadar hematokrit, kadar fibrinogen, dan nilai mRS yang bermakna secara statistik pada stroke iskemik subakut dan kronis dengan dan tanpa komorbid gagal jantung. Perlu penelitian lebih lanjut dengan jumlah sampel yang lebih besar.

---

Background. Ischemic stroke and heart failure are major health problems in the world. Both have the same risk factors so they often appear together as comorbidities. Both are also associated with impaired blood viscosity and worse functional outcomes. This study aims to assess the comparison of blood viscosity values and functional outcomes of subacute and chronic ischemic stroke patients with and without heart failure.

Methods. This study used a case-control design which was conducted at the Neurology outpatient clinic at RSUPN dr. Cipto Mangunkusumo in March and April 2023. Univariate, bivariate, and multivariate analyzes were carried out as needed.

Result. In this study, there were 24 subacute and chronic ischemic stroke patients with concomitant heart failure and 24 such patients without such a condition. There are no means differences in all of the study variables, which included blood viscosity values (5.45 0.77 poise vs. 5.50 0.77 poise, p = 0.85; plasma viscosity values (1.78 0.31 poise vs. 1.80 0.32 poise, p = 0.87); hematocrit levels (38.42 4.78% vs. 40.43 4.25%, p = 0.13); fibrinogen levels (401.03±121.18mg/dL vs 346.49±70.07mg/dL); and mRS value (2(0-4) vs 1(0-3), p = 0.37).

Conclusion. There were no statistically significant differences in mean blood viscosity, plasma viscosity, hematocrit levels, fibrinogen levels, and mRS values in subacute and chronic ischemic stroke with and without comorbid heart failure. Further research is needed with a larger sample."

"Latar Belakang: Stroke merupakan penyebab kecacatan fisik jangka panjang dan mental pada usia produktif sehingga akan berdampak pada keadaan psikologis dan sosioekonomi keluarga. Penderita stroke membutuhkan perawatan yang intensif serta memerlukan dukungan dari keluarga. Pemikiran utama setelah stroke bagi penderita dan keluarganya adalah prospek penyembuhan. Penelitian sebelumnya menunjukkan terdapat beberapa faktor yang memmpengaruhi keluaran pasca stroke seperti beratnya kelainan, tekanan darah, kadar gula darah, perawatan fase akut.Tujuan: Mengetahui perbedaan derajat keterbatasan pada penderita pasca stroke terhadap tekanan darah sistolik fase akut, kadar gula darah fase akut, dan subtipe stroke.Disain dan Metode: Studi potting lintang dengan perbandingan internal antara tekanan darah sistolik fase akut, kadar gula darah fase akut. dan subtipe stroke terhadap beratnya derajat keterbatasan setelah 6 bulan awitan stroke. Keluaran fungsional dinilai dengan menggunakan skala Rankin yang dimodifikasi (mRS).Hasil: Dari 93 penderita didapatkan 80 (86%) penderita menunjukkan keluaran fungsional yang baik (skor mRS 0-2), terdiri dari 90.9% laki-laki dan 78,9% perempuan. Sebagian besar penderita (67,5%) yang mempunyai keluaran fungsional yang baik mengalami subtipe stroke sindroma lakunar (LACS), 48,75% penderita memiliki tekanan darah sistolik > 160 mmHg peda fase akut, dan 77,5% menunjukkan kadar gula darah fase akut 8-150 mgldL. Faktor yang berpengaruh terhadap keluaran fungsional setelah 6 bulan awitan stroke adalah subtipe stroke (p<0,05).Kesimpulan: Subtipe stroke merupakan faktor yang berhubungan dengan keluaran fungsional stroke setelah 6 bulan.

---

Background: Stroke causes long term physical and mental disability in productive age and impacts on family's psychology and social economy. Stroke patients need intensive care and support from their family. The main question from the patients and their family is prospect to recovery. Previous study showed that there were many factors affecting outcome in stroke patients such as severity or disability, acute blood pressure, acute blood glucose level, and treatment in acute phase.Purpose: To perceive the difference between degree of disability and acute systolic blood pressure, acute blood glucose level, stroke subtype.Design and method: Cross sectional study with internal comparison in acute systolic blood pressure, acute blood glucose level, stroke subtype aspects between group with good and poor functional outcome. Functional outcome was assessed using modified Rankin Scale (mRS).Result: From 93 patients, we have 80 (86%) patients with good functional outcome (mRS score 0-2). consist of 90.9% male and 78.9% female. Most of patients (67.5%) with good outcome had lacunar syndrome (LACS). 48.75% with systolic blood pressure > 160 mmHg, and 77.5% showed blood glucose level 8-1 50 mg/dI,. Factor that independently influenced functional outcome 6 months after stroke is stroke subtype (p<0.05).Conclusion: Stroke subtype is significant factors to functional outcome 6 months after stroke."

"Latar Belakang: Trauma kepala (cedera otak traumatika) adalah suatu trauma mekanik yang secara langsung atau tidak langsung mengenai kepala yang dapat mengakibatkan gangguan fungsi neurologis, bahkan kematian. Glasgow Coma Scale (GCS) adalah instrumen yang umum digunakan untuk menilai tingkat kesadaran pada kondisi medis akut dan trauma serta sekaligus untuk memantau kondisi pasien selama perawatan. Setelah menjalani perawatan, luaran pada pasien pun dapat dinilai menggunakan beberapa instrument seperti Glassgow Outcome Scale. Modified Rankin Scale adalah suatu instrument untuk mengukur tingkat disabilitas pasien yang biasanya terkena stroke, tujuan penelitian ini untuk melihat GCS sebagai prediktor terhadap luaran pasien trauma menggunakan GOS dan mRS.Metode: Penelitian ini merupakan penelitian retrospektif potong lintang. Penelitian ini dilakukan di Departemen Bedah Saraf FKUI-RSCM pada subjek pasien yang mengalami cedera otak traumatika yang dioperasi maupun tidak dioperasi dan pernah menjalani perawatan di Intensive Care Unit periode Januari 2017 hingga Desember 2020.Hasil: Dalam kurun waktu dilakukan penelitian terdapat 90 (sembilan puluh) subjek pasien yang mengalami cedera otak traumatika, didapatkan 21,1%, 44,4% dan 34,4% pasien dengan GCS 3-8; 9-12;13-15 secara berurut pada saat masuk IGD. Terdapat 24,4%, 48,9%, 26,7% pasien dengan GCS 3-8; 9-12; 13-15 secara berurut pada saat preoperasi. Terdapat 41,1%, 35,6%, dan 23,3% pasien dengan GCS 3-8; 9-12; 13-15 secara berurut pada saat pascaoperasi. Terdapat 18,9%, 24,4%, dan 56,7% pasien dengan GCS 3-8; 9-12; 13-15 secara berurut pada saat keluar dari ICU. Terdapat 17,8%, 22,2% dan 60% pasien dengan GCS 3-8; 9-12; 13-15 secara berurut pada saat rawat jalan dan terdapat 20%, 8,9% dan 71,1% pasien dengan GCS 3-8; 9-12; 13-15 secara berurut pada saat 6 bulan pasca rawat jalan.Kesimpulan: Pasien yang masuk ke IGD dengan GCS 3-8 masih memiliki peluang sekitar 50% untuk memperoleh luaran yang baik dengan manajemen yang adekuat. Terjadi peningkatan GCS yang signifikan dan luaran yang baik terjadi pada pasien dengan modal GCS 9-12 maupun 13-15 saat keluar dari ICU, jika pasien keluar ICU dengan GCS 3-8 maka sekitar 90% pasien akan memiliki luaran yang buruk. MRS memiliki hasil luaran yang hampir serupa dengan GOS sehingga dapat digunakan sebagai penilaian luaran pasien cedera otak traumatika.

---

Background: Traumatic Brain Injury (TBI) is a type of mechanical trauma that occurs direct or indirectly hit the brain and can disturb neurological function until dead. Glassgow Coma Scale (GCS) is an instrument that commonly used to measure level of consciousness in an acute medical situation such as trauma and to monitor the level of consciousness while in the hospital. After getting discharged , the outcome is measured by some instrument such as Glassgow Outcome Scale. Modified Rankin Scale also a type of instrument measures disability level that usually applied on stroke patients. The goal of this study is to look GCS for an instrument to predict outcome of traumatic brain injury patients using GOS and mRS as outcome measurement scale.

Methods: This study is a cross-sectional retrospective study that conducted in Neurosurgery Department FKUI-RSCM on patients that experienced traumatic brain injury, operated or not, and treated in the Intensive Care Unit start from January 2017 until December 2020.

Results: There were 90 patients that experienced traumatic brain injury. We got 21,1%, 44,4% and 34,4% patients with GCS 3-8; 9-12;13-15 respectively when arrived at emergency room. There were 24,4%, 48,9% and 26,7% patients with GCS 3-8; 9-12; 13-15 respectively in preoperative period. There were 41,1%, 35,6%, and 23,3% patients with GCS 3-8; 9-12; 13-15 respectively in postoperative period. There were 18,9%, 24,4% and 56,7% patients with GCS 3-8; 9-12; 13-15 respectively when discharged from ICU. There were 17,8%, 22,2% and 60% patients with GCS 3-8; 9-12; 13-15 respectively discharged from hospital and there were 20%, 8,9% dan 71,1% patients with GCS 3-8; 9-12; 13-15 respectively in 6 months postoperative follow-up.

Conclusion: Patient admitted to emergency room with GCS 3-8 still have an equal chance of survival around 50% of good outcome with adequate management. There were significant escalation of GCS and good outcome happened with patients that had GCS 9-12 and 13-15 when they discharged from ICU. If patient discharge from ICU with GCS 3-8 then they would have gone to a bad outcome (90%). MRS had a similar results with GOS, therefore it can be a useful tool to measure an outcome for traumatic brain patient."

"Latar belakang: Dehidrasi sering terjadi pada stroke iskemik akut SIA dan secara teoretik dapat memperburuk luaran pasien dengan menurunkan curah jantung dan meningkatkan viskositas darah sehingga menurunkan aliran darah otak. Tujuan penelitian ini adalah untuk mengetahui apakah dehidrasi dapat memperburuk luaran klinis dan fungsional SIA. Metode: Studi kohort dilakukan antara Oktober 2016-April 2017. Sebanyak 44 subjek ikut penelitian dan dibagi menjadi 2 kelompok berdasarkan rasio ureum/kreatinin darah dan osmolalitas serum. Dehidrasi didefinisikan sebagai rasio ureum kreatinin 332,1 atau osmolalitas darah >310 mOsm/kg pada hari pertama masuk rumah sakit. Luaran diukur dengan 2 skala: 1 perbedaan nilai National Institutes of Health Stroke Scale NIHSS pada hari pertama dan ke-7 pascaawitan; dan 2 nilai modified Rankin scale mRS pada hari ke-30 pascaawitan. Hasil: Sebanyak 44 subjek ikut serta dalam penelitian dehidrasi, n = 21; kontrol, n = 23 . Sebanyak 25 subjek 57 adalah pria; 4 subjek 9 mengalami partial anterior circulation infarct PACI dan 40 subjek 91 mengalami lacunar infarct LACI . Dehidrasi tidak berhubungan dengan perburukan NIHSS nilai p = 0.176 atau nilai mRS-30-hari yang buruk nilai p = 1.00 . Satu-satunya variabel yang berhubungan dengan perburukan NIHSS atau nilai mRS-30-hari yang buruk adalah PACI nilai p masing-masing 0.003 and 0.001. Kesimpulan: Dehidrasi tidak berhubungan dengan perburukan NIHSS atau nilai mRS-30-hari yang buruk. Studi lebih lanjut dibutuhkan dengan kriteria diagnostik dan luaran yang lebih baik.

---

Background: Dehydration occurs frequently in patients with acute ischemic stroke AIS and theoretically can worsen patient rsquo s outcome by decreasing cardiac output and increasing blood viscosity resulting in decreased cerebral blood flow. The aim of this study was to determine whether dehydration worsened clinical and functional outcome of AIS.

Method: A cohort study was performed between October 2016 and April 2017. There were 44 subjects with AIS recruited. Subjects were divided into 2 groups on the basis of blood ureum creatinine ratio and serum osmolality. Dehydration is defined as ureum creatinine ratio 332,1 or blood osmolality 310 mOsm kg at admission day. Outcome was measured with 2 scale 1 National Institutes of Health Stroke Scale NIHSS score difference on admission compared to score at day 7 of hospitalization and 2 modified Rankin scale mRS at day 30 after AIS onset.

Result: A total of 44 subjects were enrolled dehydration, n 21 control, n 23. 25 subjects 57 were male 4 subjects 9 had partial anterior circulation infarct PACI and 40 subjects 91 had lacunar infarct LACI . Dehydration was not associated with either NIHSS worsening p value 0.176 or poor 30 day mRS p value 1.00 . The only variable associated with poor NIHSS and mRS outcome was PACI p value 0.003 and 0.001, respectively.

Conclusion: This study found that dehydration in AIS was not associated with poor 7 day NIHSS and 30 day mRS outcome. Further study with better diagnostic and outcome criteria is required. "

"ABSTRAKLatar Belakang: Stroke merupakan salah satu penyebab utama tingginya angka kematian dan disabilitas di dunia dengan etiologi utama iskemik. Stroke iskemik disebabkan emboli atau trombus yang menyumbat arteri otak sehingga timbul inti infark yang dikelilingi penumbra iskemik. Untuk mengembalikan sirkulasi penumbra iskemik diperlukan terapi reperfusi, salah satunya trombolisis intravena dengan Alteplase. Dari berbagai pusat studi penggunaan Alteplase berbeda-beda dalam waktu awitan-terapi dan dosis terapi, yaitu awitan terapi 3 hingga 6 jam dan dosis standard 0,9 mg/kgBB dibandingkan dengan dosis rendah 0,6 mg/kgBB. Metode Penelitian: Penelitian berupa studi potong lintang serial untuk menilai manfaat persentase perbaikan NIHSS dan mRS serta keamanan angka kejadian perdarahan intraserebral simtomatik dan kematian penggunaan alteplase dosis 0,6 mg/kgBB pada stroke iskemik akut 4 nilai NIHSS pada 24 jam pasca-trombolisis. 55,4 memiliki luaran baik berdasarkan mRS 90 hari. 7,4 mengalami perdarahan intraserebral 7 hari pasca-trombolisis. Sebanyak 10,2 subjek mengalami kematian dengan 5,6 meninggal dengan penyebab serebral. Kesimpulan: Alteplase dosis 0,6 mg/kgBB bermanfaat dan aman diberikan pada stroke iskemik akut

---

ABSTRACT<>br>Background Stroke is a leading cause of mortality and disability globally with major ischemic etiology. Ischemic stroke caused by thrombus or embolus that lodges in cerebral artery causing infarct core and surrounded by ischemic penumbra. To restore ischemic penumbral circulation, reperfusion therapy is required, one of them is intravenous thrombolysis with Alteplase. Many centers have different use of Alteplase within onset to treatment time and therapeutic doses, i.e. onset to treatment 3 to 6 hours and the standard dose of 0.9 mg kg compared with low dose 0.6 mg kg. Methods Serial cross sectional study to assess the efficacy percentage improvement of NIHSS and mRS and safety symptomatic intracerebral haemorrhage and death with Alteplase 0.6 mg kg in acute ischemic stroke 4 point NIHSS at 24 hours post thrombolysis. 55.4 had good outcomes based on mRS 90 days. 7.4 experienced intracerebral hemorrhage at 7 days post thrombolysis. 10.2 of subjects suffered death with 5.6 died with cerebral causes. Conclusion Alteplase dose 0.6 mg kg is beneficial and safe for acute ischemic stroke "

"Pendahuluan: Perdarahan Intraventrikel Intraventricular Hemorrhage / IVH merupakan perdarahan spontan yang terjadi di dalam sistem ventrikel, 30-45 sering berhubungan dengan Intracerebral Hemorrhage ICH . Evaluasi aktifitas sehari-hari yang akurat dan tepat pada pasien pasca stroke sangat penting untuk kualitas perawatan dan pengukuran luaran pasca perawatan stroke. Modified Rankin Scale mRS merupakan skala pengukuran disabilitas yang dipakai secara global untuk evaluasi pemulihan dari stroke. Tujuan: Menelaah data luaran penderita perdarahan intraventrikel yang dilakukan operasi di Departemen Bedah Saraf Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo berdasarkan mRS. Metode: Penelitian ini merupakan penelitian retrospektif dengan desain potong lintang cross sectional . Adapun variabel independent yaitu lokasi lesi perdarahan intraserebral, IVH-skor, GCS awal, dan variabel dependent yaitu luaran berdasarkan skoring mRS. Subjek penelitian adalah semua pasien penderita perdarahan intraventrikel yang dikelola Departemen Bedah Saraf RSUPN Cipto Mangunkusumo selama periode Januari 2010 sampai dengan Agustus 2016. Jumlah sampel pada penelitian ini didapatkan 23 sampel. Data penelitian diperoleh melalui catatan rekam medis, subjek dihubungi via telepon, kemudian subjek atau keluarga diwawancara untuk menilai status fungsionalnya dengan mRS. Data diolah dengan menggunakan program SPSS 21. Hasil: Luaran 6 bulan IVH dengan menggunakan mRS secara keseluruhan didapatkan independent 11 pasien 47,8 dependent 4 pasien 17,3 dan 8 pasien meninggal 34,9 . IVH sebagian besar berusia di bawah 60 tahun 60,8 dan 39,2 yang berusia diatas 60 tahun, dari penelitian didapatkan IVH skor terbanyak adalah >15 sebanyak 15 pasien 65,2 . GCS rata-rata 7,6 2,14 . MAP terbanyak adalah >100 dengan jumlah 20 pasien 87 , dan faktor resiko yang mengalami hipertensi sebanyak 19 pasien 82,6. Diskusi: mRS dapat digunakan sebagai standar penilaian luaran IVH.

---

Introduction: Intraventricular hemorrhage IVH is a spontaneous hemorrhage occurring within the ventricular system, 30 40 often associated with Intracerebral hemorrhage ICH, Accurate and precise daily evaluating activity in post stroke patients is critical for the quality of care and measurement of post stroke outcomes. Modified Rankin Scale mRS is a global disability measurement scale used for the evaluation of stroke recovery.

Aims: Configuring outcome data of patient with intraventricle hemorrhage operated at neurosurgery departmen of cm hospital based on mRS.

Methods This was an observational study with cross sectional design. The independent variables are location of intracerebral hemorrhage lesion, IVH score, initial GCS, and dependent variable is outcome based on mRS scores. Subjects of research were all patients with intraventricular hemorrhage administered by Department of Neurosurgery Cipto Mangunkusumo Hospital during January 2010 until August 2016 period. The number of samples in this study were obtained 23 samples. Research data was obtained through medical record and transferred into data entry format, patients was contacted by telephone, then patients or family were interviewed to assess their functional status with Modified Rankin Scale. Data is processed by using SPSS 21 program.

Results: 6 months IVH overall outcomes are 11 independent patients 47.8 4 dependent patients 17.3 and 8 patients died 34.9. IVH were mostly under 60 years old 60,8 and 39,2 were aged over 60 years, from the study obtained IVH most scores were 15 as many as 15 patients 65.2. GCS averages 7.6 2.14 . Most MAPs were 100 with 20 patients 87, and hypertension risk factors were 19 patients 82.6.

Discussion: mRS can be used as standard outcome assessment of IVH."

"Inflammatory response in the acute phase of ischemic stroke will trigger the process of neuroplasticity and determine the clinical outcomes. Angiogenesis and neurogenesis are induced by expression of vascular endothelial growth factor (VEGF) in the acute phase of stroke. The purpose of this study was to determine the association between VEGF serum level in acute of stroke with the clinical outcomes. This longitudinal cohort study was conducted on 64 patients suffering from first-attack of anterior circulation blockage as evidenced by cephalic diffusion-weighted magnetic resonance imaging (DWI). VEGF serum level was measured at 72 hours and 7 days after stroke and the clinical outcomes were assessed on day 30 post-stroke using the National Institutes of Health Stroke Scale ( NIHSS). VEGF level at hour-72 and on day-7 were 5.84+-0.736 ng/mL and 5.797 +-0.96 ng/mL, respectively (p>0.05). High VEGF levels at hour-72 can be used to predict poor clinical outcome 30 days after stroke (OR=6.5; 95% CI = 1.15-36.61 ; p=0.034). Subjects who have increasing levels of VEGF on day-7 compared to hour-72 tend to have better clinical outcomes on day-30 (NIHSS score =1.33 +-1.22 vs 3+-3.78; p=0.232). VEGF levels in the acute phase of ischemic stroke reflect the degree of brain damage, the dynamic of the increase in VEGF levels after a stroke was associated with better clinical outcomes."

"Latar Belakang: Perdarahan intraserebral spontan (PISS) berkaitan dengan luaran yang buruk dibandingkan dengan infark serebral, dapat menyebabkan disabilitas berat, yaitu menyebabkan kecacatan fisik, psikologis, dan fungsi sosial. Pada pasien yang secara CT scan terbukti terdapat hematom intraserebral supratentorial, pembedahan dan perawatan neurointensif mengurangi angka kematian atau kecacatan dibandingkan hanya dengan terapi medis saja. Pembedahan yang dilakukan dapat meningkatkan luaran pasien dengan PISS yang selektif. Tujuan: Menilai luaran 6 bulan pasca operasi penderita perdarahan intraserebral spontan supratentorial yang di kelola Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2013-Agustus 2014 serta faktor-faktor yang mempengaruhi luaran tersebut. Metode: Penelitian ini merupakan penelitian potong lintang terhadap pasien perdarahan intra serebral spontan supratentorial yang dilakukan operasi evakuasi hematom di Departemen Bedah Saraf RSUPN Dr. Cipto Mangunkusumo periode Januari 2013-Agustus 2014 menggunakan modified Rankin Scale (mRS). Data penelitian ini diperoleh melalui catatan rekam medis. Hasil: Luaran 6 bulan setelah dilakukan operasi didapatkan luaran independent 7 pasien (38,9%) dan dependent 11 pasien (61,1%). Tidak didapatkan pasien meninggal selama follow up 6 bulan setelah operasi dari data ini. Berdasarkan lokasi perdarahan supratentorial, perdarahan lobar dengan luaran lebih baik dimana luaran independent 50% dibandingkan perdarahan deep seated dengan luaran independent 16,7%. Faktor faktor yang mempengaruhi seperti jenis kelamin, GCS, volume hematom, komorbiditas hipertensi serta diabetes melitus dan jenis tindakan tidak dapat dilakukan uji kemaknaan karena jumlah sampel yang sedikit. Kesimpulan: Luaran 6 bulan PISS supratentorial pasca operasi evakuasi hematom secara keseluruhan didapatkan lebih banyak dependent dibandingkan independent, dimana pasien perdarahan intraserebral spontan supratentorial lobar lebih baik dibandingkan dengan deep seated.

---

Background: Spontaneous intracerebral hemorrhage associated with poor outcomes compared with cerebral infarction, can cause severe disability, that causes physical disability, psychological, and social functioning. In patients who are the CT scan proved there supratentorial intracerebral hematoma, surgery and neurointensive care reduce mortality or disability compared only with medical therapy alone. Surgery can improve the outcome of patients with selective spontaneous intracerebral hemorrhage.

Purpose: Assessing outcomes 6 months postoperatively supratentorial spontaneous intracerebral hemorrhage patients who managed the Department of Neurosurgery Dr. Cipto Mangunkusumo Hospital, the period January 2013-August 2014 and the factors that affect these outcomes.

Method: A cross sectional study on patients with supratentorial spontaneous intracerebral hemorrhage and evacuation operation conducted in the Department of Neurosurgery Dr. Cipto Mangunkusumo Hospital the period January 2013-August 2014. Evaluate outcomes using the modified Rankin Scale (mRS). The research data was obtained through medical record.

Result: Outcome 6 months after surgery obtained independent outcomes 7 patients (38.9%) and dependent 11 patients (61.1%). There were no patients died during the follow-up 6 months after surgery of this data. Based on the location supratentorial hemorrhage, lobar hemorrhage with better outcomes in which the outcome of the independent 50% compared to the deep-seated bleeding with independent outputs of 16.7%. Factors influencing such as sex, GCS, hematoma volume, comorbid hypertension and diabetes mellitus and type of action can not be performed because of the significance of test sample size slightly.

Conclusion: Outputs 6 months postoperatively PISS supratentorial hematoma evacuation as a whole gained more dependent than independent, which supratentorial spontaneous intracerebral hemorrhage patients with lobar better than the deep-seated."

"Tujuan: Mendapatkan alat (Mikrokapiler Digital/MD) untuk mengukur viskositas darah dan plasma yang mempunyai presisi dan akurasi yang baik. Mengetahui peran viskositas darah dan plasma yang diukur dengan MD, faktor risiko dan determinan terhadap prognosis stroke iskemik akut berdasarkan National Institute of Health Stroke Scale (NIHSS), Modified Rankin Score (mRS), Interleukin 6 (IL-6), dan neuron-specific enolase (NSE). Penelitian tahap pertama meliputi uji presisi dan akurasi, sedangkan tahap kedua adalah uji prognosis. Subjek penelitian: Subjek untuk uji presisi adalah 40 dewasa sehat yang melakukan Medical Check Up (MCU). Subjek untuk uji akurasi dan prognosis adalah 135 pasien stroke iskemik akut onset ≤ 3 hari, usia 35 – 74 tahun. Pengukuran dan intervensi: Presisi dinilai dengan coefficient of variation (CV), interrater variability Cronbach Alpha dan coefficient of reliability Bland Altman. Akurasi dinilai dengan uji diagnostik. Uji prognosis meliputi analisis bivariat dilanjutkan dengan analisis multivariat cox proportional hazards regression. Hasil: Dari penelitian tahap pertama, didapatkan CV sebesar 0,04, nilai interrater variability Cronbach Alpha dan mean difference Bland Altman adalah baik. Sensitivitas dan spesifisitas MD untuk viskositas darah adalah 88,9 % dan 88,9 %, sedangkan untuk viskositas plasma adalah 100 % dan 84 %. Rumus prediksi untuk konversi viskositas darah MD ke satuan poise adalah y = 0,846x + 0,614, dan untuk viskositas plasma adalah y = 1,072x + (-0,160). Pada uji tahap kedua, didapatkan faktor determinan antara lain: fibrinogen merupakan faktor determinan perubahan viskositas darah dan plasma; viskositas darah merupakan faktor determinan perburukan kondisi klinis (National Institute of Health Stroke Scale/NIHSS dan modified Rankin Scale/mRS); viskositas darah dan diabetes melitus (DM) merupakan faktor determinan prognosis stroke iskemik akut berdasarkan interleukin 6 (IL-6); dan HDL merupakan faktor determinan prognosis stroke iskemik akut berdasarkan neuron specific enolase (NSE). Simpulan: MD memiliki presisi dan akurasi yang baik. Viskositas darah merupakan faktor determinan perburukan kondisi klinis baik akut maupun pasca perawatan.

---

Objectives: To design a simple and portable instrument (Digital Microcapillary) for measuring blood and plasma viscosity values with high precision and accuracy. To assess the roles of these values, the risk and determining factors in predicting the outcome of acute ischemic stroke assessed using National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), interleukin 6 (IL-6), and neuron specific enolase (NSE). The first stage of this study included precision and accuracy tests, while the second stade was the prognostic test.

Research subjects: 40 healthy adults admitted for Medical Check Up (MCU) were recruited for the precision test while the subjects for accuracy and prognostic tests were 135 acute ischemic stroke patients, either inpatients or outpatients, aged 35 - 74 years old, with up to 3 days stroke onset.

Measurement and intervention: The precision was assessed by calculating coefficient of variation (CV), Cronbach Alpha interrater variability, and Bland Altman coefficient of reliability, while the accuracy was assessed using diagnostic test. The prognostic test included bi- and multivariate analyses using Cox proportional hazards regression.

Results: The results of the first stage study were that the CV was 0.04; Cronbach Alpha interrater variability and Bland Altman mean difference values were excellent. The prediction formula used to convert blood viscosity value measured with digital microcapillary to poise unit was y = 0.846x + 0.614, and the formula for plasma viscosity was y = 1.072x + (-0.160). The sensitivity and specificity of Digital Microcapillary for blood viscosity measurement were 88.9 % and 88.9 %, respectively and for plasma viscosity measurement were 100 % and 84 %, respectively. The second stage of the study showed that the variables proven to be the determinants were: fibrinogen as the determinant of blood and plasma viscosity, blood viscosity as the determinant of clinical outcome (NIHSS and mRS), blood viscosity and diabetes mellitus as the determinants of acute ischemic stroke outcome indicated by blood IL-6 level, and HDL as the determinant of acute ischemic stroke outcome indicated by NSE level.

Conclusions: Digital Microcapillary has high precision and accuracy. Blood viscosity is a determining factor in the ischemic stroke outcome, both acute and one month after hospital discharge."