Hasil Pencarian  ::  Simpan CSV :: Kembali

"Principles of metabolic surgery“ delivers a succinct account of current knowledge and an excellent overview of modern treatment strategies for morbid obesity. Attractively designed, this user-friendly textbook provides the latest on therapy, monitoring, and management, including: -Completely up-to-date coverage of modern metabolic surgery. Current understanding of the pathophysiology of morbid obesity. Current clinical therapy strategies for conservative and surgical approaches. Recent references In concise, readable chapters, this well-illustrated textbook outlines major concerns and considerations surrounding metabolic surgery. With respect to new insights from basic and clinical research, clear guidelines and practical clinical advice are given to improve the outcome of treatment for morbid obesity."

"The increasing prevalence of obesity in many countries means that it should now be considered a pandemic. It is widely recognized that obesity increases the risk of a variety of life-threatening conditions, including heart disease, diabetes, and hypertension. Bariatric surgery is often the most effective way to treat such morbid obesity. Nevertheless, while various bariatric procedures have been proposed, to date standards have been lacking. In this book, leading experts from around the world discuss all aspects of bariatric surgery and present their own favored versions of surgical procedures with the aid of informative illustrations. Technical nuances are carefully described, and detailed attention is devoted to potential complications and how to avoid them. "

"Mutu pelayanan Rumah Sakit di Indonesia sangat bervariasi. Keadaan ini mendorong Pemerintah melalui Depkes Rl untuk menetapkan standar baku tarif dan mutu Rumah Sakit yang berlaku secara nasional melalui suatu sistem Case mix dengan nama INA DRG Depkes. Namun dalam kenyataan penempan tarif INA DRG Depkes menimbulkan polemik bagi pihak Rumah Sakit. Tujuan penelitian ini adalah untuk mengetahui penetapan cost of treatment berbasis clinical pathway kasus kanker payudara dengan tindakan bedah masektomi radikal modifikasi dan kemoterapi FAC dengan tarif INA DRG Depkes di Rumah Sakit Kanker Dharmais tahun 2008. Hasil penelilian menunjukkan adanya perbedaan pengelompokan kanker payudara menurut AR DRG versi 5.2 dimana ditemukan penyakit penyerta DM, asma, hipertensi, dan penyakit penyulil anemia. Lama hari rawat tidak berbede di setiap diagnosa. Perbedean hanya terletak pada jenis obat yang diberikan yang disesuaikan dengan penyakit yang menyertai. Pada tarif INA DRG Depkes penempan tarif melalui rata-rata data yang dikirimkan oleh 15 Rumah Sakit tanpa adanya clinical pathway dan cost of treatment. Tindakan bedah MRM payudara dan cost of treatment FAC berada lebih tinggi daripada tarifiNA DRG Depkes. Penelitian ini belum menggambarkan seluroh penatalaksanaan pada kanker payudara, sehingga disarankan untuk d.ilakukan penelitian Jebih lanjut khususnya untuk penetapan COT radiotherapi yang mengikuti tindekan bedah MRM dan kemoterapi. Kami sarankan kepada Depkes Rl untuk melengkapi tarif INA DRG Depkes agar dapat membuat clinical pathway sebsgai standar utilisasi pelayanan kesebatan dan selalu melakukan revisi daftar tarif INA DRG Depkes setiap tahun agar dapat mempertahankan mutu pelayanan Rumah Sakit.

---

The Quality service of Hospital in Indonesia is highly varied. This situation make the Government through Depkes RI to specify the standard of the Hospital quality and tariff applied nationally through a Case mix system by the name of INA DRG DEPKES. But in reality of applying of tariff INA DRG DEPKES generate polemic for Hospital.

This research purpose is to know the cost of treatment based on clinical pathway breast cancer case with Modified Radical MMastectomy nd F AC Chemotherapy with INA DRG Depkes tariff at Dharmais Cancer Hospital year of2008.

Research result show the difference of breast cancer grouping according to AR DRG version of5.2 where found DM disease, asthma, hypertension, and anaemia. Every diagnosis have the same length of stay. Difference only in the given drug type based on disease accompanied. INA DRG Depkes tariff based on data delivered by 15 Hospital without existence of clinical pathway and cost of treatment. Surgery on MRM breast cancer and cost of treatment FAC higher than INA DRG Depkes tariff. This research not yet show the entire breast cancer surgery, we suggest to do a further research spceially on Cost of Treatment radiotherapy following the action operate on MRM and chemotherapy.

We suggest to Depkes RI to complete the INA DRG Dcpkes tariff so that they can make clinical pathway as standard service utility of health and always revise the INA DRG Depkes tariff list every year so that they can maintain the quality service of Hospital."

"ABSTRAKKanker payudara adalah kanker pada jaringan payudara. Kanker ini merupakan kankeryang paling umum diderita wanita. Pengalaman dan pengobatan kanker tersebutmempunyai pengaruh yang besar dalam kualitas hidup pasien, seperti kelemahan,nausea dan nyeri. Efek samping atau keluhan dari kanker dan pengobatannya cenderungmeningkat selama perawatan dan dapat menetap selama berbulan-bulan atau bertahuntahun.Untuk mencapai proses penyembuhan dan pemulihan yang baik pada pasienkanker payudara pasca mastektomi perlu adanya manajemen nyeri yang tepat. Penelitianini bertujuan mengidentifikasi pengaruh latihan fisik terhadap nyeri pada pasien kankerpayudara pasca mastektomi di RSUD Dr. Achmad Mochtar Bukittinggi. Desainpenelitian ini adalah quasi eksperiment, khususnya non-equivalent control group denganpre dan post test. Sampel berjumlah 30 orang (15 orang kelompok intervensi yangdiberikan 7 hari latihan fisik ditambah analgesik dan 15 orang kelompok kontrol yangdiberikan terapi standar analgesik), yang diambil dengan metode non probabilitysampling jenis consecutive sampling. Evaluasi tingkat nyeri dilakukan setiap hari baikpada kelompok intervensi maupun kelompok kontrol. Hasil penelitian diperoleh adanyapenurunan tingkat nyeri setiap harinya, baik pada kelompok intervensi maupun kelompokkontrol. Penurunan yang lebih besar terjadi pada kelompok intervensi (p=0,000), artinyalatihan fisik pada pasien kanker payudara pasca mastektomi dapat berpengaruh terhadappenurunan tingkat nyeri. Rekomendasi hasil penelitian ini perlu adanya penelitian lanjutdengan jumlah sampel yang lebih besar dan dilanjutkan dengan perawatan di rumah sertadapat di jadikan salah satu intervensi keperawatan dalam menangani manajemen nyeripasca mastektomi.

---

ABSTRACTBreast cancer is one of the common types of cancer among women. The trajectory of theexperience for having the disease and its trestment are believed to produce a big effect onthe quality of life of the patients. The experiences such as weaknesses, nauseated, andpain have to be through by the patients on the daily bases. This side effects andcomplaints created form the cancer and its therapy tend to increase during hospitalizationand can be pertinent for months or ever years. Therefore, to achieve a better healing andrecovery processes for the breast cancer patients especially post mastectomy requires theright pain management.The purpose of this study is to identify the effect of physical exercise on pain perceivedby the breast cancer patient after mastectomy at Dr Achmad Mochtar General Hospital,Bukittinggi. The design was a quasi experimental using a non-equivalent control groupwith pre and post test approach. There was 30 subjects participated in the study dividedtwo groups (the intervention group was provided with analgesic and seven days physicalexercise; and, the control group was provided with analgesic only); 15 subjects for eachgrup. A non probability sampling method-consecutive type was utilized to gather thesubjects. The pain was evaluated each day to both groups.The findings of the study demonstrated that there is a daily pain reduction between bothgroups. Further, the comparison of the pain reduction between these two group leads tothe bigger pain reduction in the intervention group compared to the control group(p=0.000). This finding showed that the physical exercise provided to the postmastectomy-breast cancer patients has a significant effect to reduce the pain level. Thiswith home care; also this finding can be used as a foundation to involve physicalexercise as on of the nursing intervention in managing post mastectomy pain commonlyexperienced by breast cancer patients."

"Latar Belakang:Kanker payudara merupakan kanker dengan jumlah tertinggi pada perempuan di dunia. Meningkatnya angka ketahanan hidup pasien kanker payudara, membuat meningkatnya insiden terjadinya limfedema diakibatkan komplikasi dari Modified Radical Mastectomy(MRM). Belum diketahui apakah ada pengaruh dilakukannya flap jaringan di daerah diseksi kelenjar getah bening pada kanker payudara dengan perbaikan aliran limfe pada daerah tersebut. Tujuan dari penelitian ini adalah mengetahui adanya regenerasi limfatik pada flap jaringan pasien kanker payudara pasca mastektomi dan diseksi aksila.Metode Penelitian: dilakukan penelitian menggunakan desain kuasi eksperimen pada semua pasien kanker payudara yang dilakukan Modified Radical Mastectomy (MRM) dan diseksi aksila dengan menggunakan flap untuk mengurangi kejadian limfedema pasca operasi. Data diambil pada periode januari 2018 sampai Mei 2019Hasil : Terdapat 32 pasien kanker payudara pasca tindakan MRM dan diseksi aksila (16 pasien dengan flap dan 16 pasien tanpa flap). Dari 16 pasien yang dilakukannya flap, terdapat 14 pasien yang mengalami regenerasi limfatik (87,5%) dan 2 pasien yang tidak mengalami regenerasi limfatik (12,5%) pasca pemasangan flap jaringan pada pasien MRM. Terdapat hubungan antara penggunaan flap (p = 0,049 dengan OR 95%CI 5,43 (2,22-32,2)) dan usia (p = 0.042 dengan OR 95%CI0,2 (0,03-0,95))terhadap regenerasi limfatik.Kesimpulan : Terdapat hubungan yang berbeda bermakna antara flap jaringan dengan tanpa flap pada daerah diseksi kelenjar limfe dengan regenerasi limfatik pada daerah tersebut. Tidak terdapat hubungan berbeda bermakna antara komorbid, riwayat radiasi, indeks masa tubuh, stadium TNM, terhadap regenerasi limfatik.

---

Background : Breast cancer is the most common cancer in women in the world. Increased survival rates of breast cancer patients, making the increased incidence of lymphedema caused by complications from Modified Radical Mastectomy (MRM). It is not known yet whether there is an effect of doing tissue flap in the area of ​​lymph node dissection in breast cancer with improved lymph flow in the area. The purpose of this study was to determine the presence of lymphatic regeneration in tissue flap of breast cancer patients after mastectomy and axillary dissection.

Research Method : Conducted a study using quasi-experimental design in breast cancer patients with MRM and axillary dissection alone or by using a flap to reduce the incidence of postoperative lymphedema. Data is taken from January 2018 to Mei 2019.

Results : There were 32 breast cancer patients after MRM and axillary dissection (16 patients with flaps and 16 patients without flap). Of the 16 patients who were replaced by flaps, 14 patients needed lymphatic regeneration (87,5%) and 2 patients who did not need lymphatic regeneration (12,5%) after tissue flaps procedure in MRM patients. There is a relationship between the use of flap (p = 0.049 with OR 95% CI 5,43 (2,22-32,2)) and age (p = 0.042 with OR 95% CI 0,2 (0,03-0,95)) to lymphatic regeneration.

Conclusions : There is a significantly different relationship between tissue flaps and without flaps in the area of ​​lymph node dissection with lymphatic regeneration in the area. There is no significant difference between comorbidities, radiation history, body mass index, TNM stage, and lymphatic regeneration."

"ABSTRAKKanker payudara merupakan tumor ganas pada jaringan payudara yang bersifat invasif dan paling sering terjadi pada wanita. Mastektomi adalah salah satu operasi kanker payudara yang mengangkat jaringan payudara beserta otot pektoralis dan nodus limfe aksila. Komplikasi lebih lanjut pada pasien yang menjalani operasi mastektomi dan diseksi nodus limfe aksila yaitu terjadinya limfedema. Studi kasus ini dilakukan untuk menganalisis intervensi keperawatan berupa latihan mobilisasi lengan pada pasien kanker payudara pasca operasi mastektomi dan diseksi nodus limfe aksila. Hasil intervensi menujukkan adanya pengaruh signifikan dari pemberian latihan mobilisasi lengan pada pasien yang ditandai dengan penurunan tingkat nyeri dan peningkatan kekuatan otot, serta tidak adanya kemerahan, edema, kesemutan dan kekakuan pada lengan. Rekomendasi dari studi kasus ini adalah perawat perlu mengetahui tanda dan gejala limfedema pada pasien kanker payudara, sehingga komplikasi pasca operasi mastektomi dan diseksi nodus limfe aksila dapat dicegah dan kualitas hidup pasien dapat meningkat.

---

ABSTRACTBreast cancer is an invasive malignant tumor in breast tissues which commonly occurred in women. Mastectomy is a breast cancer surgery which breast tissues alongside pectoral muscles and axillary lymph nodes are dissected. Further complications in patients undergoing mastectomy and dissection of axillary lymph nodes is the occurrence of lymphedema. This case study was conducted to analyze nursing intervention, which is arm mobilization exercise, in post operative mastectomy and axillary lymph nodes dissection patient. The results of the intervention showed the significant effect of arm mobilization exercise in patient proven by decreased pain levels, increased muscle strength, and absence of redness, edema, tingling and stiffness in the arms. This study recommend nurses need to know the signs and symptoms of lymphoedema in breast cancer patients. Therefore, post operative complications of mastectomy and axillary lymph node dissection can be prevented and patients rsquo quality of life may increase."

"Ruang lingkup dan Cara penelitian : Dilakukan penelitian terhadap 114 penderita kanker payudara stadium I dan II di Bagian Bedah Onkologi/HNB FKUI/RSUPNCM Jakarta dalam kurun waktu 1989-1996. Setelah dibuktikan secara histopatologi suatu keganasan, penderita selanjutnya dilakukan mastektomi radikal. Bila kelenjar getah bening terdapat penyebaran sel kanker maka diberikan terapi ajuvan berupa radiasi dan atau kemoterapi. Selanjutnya penderita diikuti sampai terjadi suatu kekambuhan, hilang dari pengamatan atau sampai penelitian berakhir.Hasil dan kesimpulan : Rerata umur penderita 45 tahun dengan rentang 22-64 dan terdapat 15% kekambuhan yang terjadi balk lokal maupun metastasis jauh. Kekambuhan terbanyak mengenai paru sebesar 32% kemudian hati dan tulang masing-masing 25%. Rerata lama pengamatan 519 hari (median 191 dan modus 39 ). Probabilitas babas penyakit sebesar 51% pada 1500 hari.Kelompok umur kurang 35 tahun dan kelompok 35-50 tahun mempunyai risiko untuk kambuh masing-masing 4 dan 6.3 kali dibanding kelompok lebih 50 tahun. Adanya penyebaran ke kelenjar getah bening meningkatkan risiko kekambuhan sebesar 6.9 kali. Ukuran tumor 2-5 cm dibanding kurang 2 cm mempunyai risiko kekambuhan 2.8 kali. Dan tipe Ca ductal Invasif mempunyai risiko yang sangat tinggi untuk kambuh dibanding tipe lainnya. Tetapi yang berrnakna secara statistik hanya penyebaran ke kelenjar getah bening dan tipe histopatologi.

---

The Role of Clinical Prognostic Factors for Stage I and II Breast Cancer Recurrence in Cipto Mangunkusumo Hospital JakartaScope and Method of study : The objective of this study is to find out the role of several prognostic factors in breast cancer recurrence for patients underwent radical mastectomy on stage I and II in Cipto Mangunkusumo Hospital Jakarta. 114 patients entered this study during the period of 1989 to 1996. The patients with positive axillary node received adjuvant therapy i.e external radiation or chemotherapy. Survival analysis were used to analyze data.

Results and conclusions : The mean age was 45 years(range 22-64 yrs). Cumulative incidence of recurrence was 15% with disease free survival 51 % at 1500 days. The most frequent site of metastasis was lung 32% then liver and bone 25% each. The mean follow up time was 519 days (median 191, mode 30).

Age group below 35 years and between 35-50 years had higher risk for a relapse, 4 and 6.3 times than group above 50 years. Positive axillary node and tumor size above 2 cm increased risk 6.9 and 2.8 times respectively. Ductal invasive type had a very high risk to recur. But only axillary node involvement and ductal invasive type were statistically significant."

"

Kanker payudara merupakan penyakit kanker yang paling banyak terjadi pada wanita. Edukasi self management dengan media booklet digital dan video pada pasien kanker payudara pasca mastektomi diperlukan untuk meningkatkan keyakinan dalam melakukan pengelolaan kesehatan mandiri dan mendukung keberlangsungan pengobatan selanjutnya, yang menjawab tantangan pergeseran sistem pelayanan kesehatan ke pelayanan berbasis digital. Penelitian bertujuan mengetahui pengaruh edukasi self management dengan media booklet digital dan video terhadap self efficacy. Tempat penelitian  RSUP DR Sardjito Yogyakarta,pada bulan Maret hingga Mei 2024, menggunakan quasi experiment pre post desing with comparison group. Jumlah sampel 30 kelompok intervensi dan 30 kelompok kontrol diambil dengan teknik purposive sampling.Data dianalisis menggunakan T-test, menunjukkan peningkatan self efficacy yang significan pada kelompok intervensi p = 0,000 (<0,05) sedangkan kelompok kontrol tidak terjadi peningkatan yang significan p=0,967. Oleh karena itu, edukasi self management dengan media booklet digital dan video dapat digunakan untuk meningkatkan keyakinanan dalam perawatan mandiri pasien kanker payudara pasca mastektomi.

---

Breast cancer is the most common cancer in women. Self-management education using digital booklets and video media for post-mastectomy breast cancer patients is needed to increase confidence in carrying out independent health management and support the continuation of subsequent treatment, which answers the challenges of shifting the health service system to digital-based services. The research aims to determine the effect of self-management education using digital booklets and video media on self-efficacy. The research site at RSUP DR Sardjito Yogyakarta, from March to May 2024, used a quasi experimental pre post design with comparison group. The total sample of 30 intervention groups and 30 control groups was taken using a purposive sampling technique. Data were analyzed using the T-test, showing a significant increase in self-efficacy in the intervention group p = 0.000 (<0.05) while there was no significant increase in the control group p= 0.967. Therefore, self-management education using digital booklets and videos can be used to increase confidence in self-care for breast cancer patients after mastectomy."