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"Peran seorang apoteker di rumah sakit salah satunya yaitu pemantauan terapi obat pasien. Pemantauan terapi obat dilakukan untuk menganalisa masalah terkait obat atau Drug Related Problem (DRP) yang terjadi pada pasien selama masa perawatan di rumah sakit. Dalam hal ini dilakukan pemantauan terapi obat pada salah satu pasien di RSUP Persahabatan dengan diagnosis Kanker Nasofaring T4N3M0 dengan Malnutrisi High Risk Refeeding Syndrome dan Penurunan Kesadaran Akibat Suspek Metastasis Intrakranial. Pasien kanker nasofaring (KNF) sering mengalami malnutrisi dengan prevalensi 35% dan sekitar 6,7% mengalami malnutrisi berat. Kejadian malnutrisi pada pasien KNF dipengaruhi oleh efek kemoradiasi terutama komplikasi oral berupa disfagia dan xerostomia. Maka dari itu, pasien yang mengalami malnutrisi membutuhkan asupan nutrisi yang cukup. Namun, pemberian nutrisi pada pasien malnutrisi dapat berisiko terjadinya Refeeding Syndrome (RFS). Refeeding Syndrome terjadi ketika pemberian nutrisi yang berlebih pada pasien malnutrisi kronik dalam waktu yang terlalu cepat atau singkat. Malnutrisi juga dapat ditandai dengan rendahnya kadar elektrolit dalam tubuh seperti hiponatremia, hipokalemia, hipomagnesia, hipofosfatemia, dan hipokalsemia. Oleh karena itu, pasien malnutrisi perlu dilakukan pemantauan kadar elektrolit dan asupan nutrisinya agar tetap seimbang serta pemantauan terapi pengobatan lainnya yang diterima pasien. Masalah terkait obat (MTO) yang ditemukan dalam proses pengobatan pasien meliputi ada indikasi tanpa obat, pemilihan obat kurang tepat, dan dosis terlalu tinggi. Peneliti memberikan rekomendasi terapi pada setiap MTO yang ditemukan selama masa perawatan pasien serta melakukan pemantauan terapi hingga obat dikonsumsi oleh pasien.

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One of the roles of a pharmacist in a hospital is monitoring patient drug therapy. Monitoring drug therapy is carried out to analyze drug-related problems or Drug Related Problems (DRP) that occur in patients during the hospital treatment period. In this case, drug therapy monitoring was carried out on one of the patients at Friendship Hospital with a diagnosis of Nasopharyngeal Cancer T4N3M0 with Malnutrition High Risk Refeeding Syndrome and Decreased Consciousness Due to Intracranial Metastatic Suspects. Nasopharyngeal cancer (KNF) patients often experience malnutrition with a prevalence of 35% and about 6.7% experience severe malnutrition. The incidence of malnutrition in KNF patients is influenced by the effects of chemoradiation, especially oral complications in the form of dysphagia and xerostomia. Therefore, patients who experience malnutrition need adequate nutritional intake. However, providing nutrition to malnourished patients can be at risk of Refeeding Syndrome (RFS). Refeeding Syndrome occurs when overnutrition in chronically malnutrition patients is too fast or short. Malnutrition can also be characterized by low levels of electrolytes in the body such as hyponatremia, hypokalemia, hypomagnesemia, hypophosphatemia, and hypocalcemia. Therefore, malnutrition patients need to monitor electrolyte levels and nutritional intake to remain balanced and monitor other treatment therapies received by patients. Drug-related problems (MTO) found in the patient's treatment process include no drug indications, improper drug selection, and too high doses. Researchers provide therapy recommendations on each MTO found during the patient's treatment period and monitor therapy until the drug is consumed by the patient."

"Penelitian ini bertujuan untuk mengetahui alat skrining malnutrisi yang sesuai untuk pasien kanker dewasa rawat inap pra bedah sehingga malnutrisi cepat dikenali dan dapat diberikan dukungan nutrisi secara dini. Penelitian ini merupakan uji diagnostik alat skrining Malnutrition Screening Tool (MST) dan Royal Marsden Nutrition Screening Tool (RMNST) dengan Subjective Global Assessment (SGA) sebagai pembanding terhadap 58 pasien kanker rawat inap pra bedah yang masuk rumah sakit kurang dari 24 jam. Sensitivitas, spesifisitas, nilai duga positif (NDP), nilai duga negatif (NDN), dan area under the curve (AUC) dihitung untuk mengetahui metode yang paling baik diantara dua alat skrining dibanding standar baku. Hasil penelitian didapatkan prevalensi malnutrisi berdasarkan SGA sebesar 34,6%. Sensitivitas, spesifisitas, NDP, NDN, dan AUC MST berturut-turut adalah 88.9%, 97%, 94,12%, 94,28%, dan 93% sedangkan sensitivitas, spesifisitas, NDP, NDN, dan AUC RMNST masing-masing adalah 94.4%, 82.35%, 73,9%, 96,55%, and 88%. Hal ini menunjukkan bahwa RMNST lebih baik dibanding MST dalam menapis malnutrisi pada pasien kanker rawat inap pra bedah.

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This study aimed to determine malnutrition screening tool which appropriate for adult hospitalized pre-surgical cancer patients, therefore, malnutrition could be recognized quickly and nutritional intervention could be provided at an early stage. This study was a diagnostic test of Malnutrition Screening Tool (MST) and the Royal Marsden Nutrition Screening Tool (RMNST) compared to Subjective Global Assessment (SGA) on 58 cancer pre-surgical inpatients who were admitted to the hospital less than 24 hours. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) were calculated to evaluate the perfomance of tools compared the standard. The result showed that the prevalence of malnutrition by SGA was 34.6%, the sensitivity, specificity, PPV, NPV, and AUC of MST were 88.9%, 97%, 94,12%, 94,28%, and 93% respectively while the sensitivity, specificity, PPV, NPPV, and AUC of RMNST were 94.4%, 82.35%, 73,9%, 96,55%, and 88% respectively. This indicated that RMNST better than MST in screening malnutrition in the cancer pre-surgical inpatients."

"ABSTRAK Latar Belakang: Malnutrisi berdampak besar pada pasien kanker sehingga harusdievaluasi dengan Patient-Generated Subjective Global Assessment (PG-SGA),namun memakan waktu dan membutuhkan tenaga kesehatan terlatih. Pengukurankekuatan genggam tangan (KGT) memiliki keuntungan lebih singkat dan mudahdibandingkan PG-SGA, tetapi belum ada data titik potong dan akurasi diagnostikKGT pada pasien kanker di Indonesia. Tujuan: Mendapatkan titik potong dan akurasi diagnostik KGT sebagai penapismalnutrisi pasien kanker rawat jalan di RSCM.Metode: Penelitian potong lintang ini dilakukan pada pasien 18-59 tahun dipoliklinik onkologi RSCM selama 4 Mei-1 Oktober 2015. Titik potong KGTdianalisis menggunakan kurva ROC. Akurasi diagnostik KGT dinilai denganmenghitung sensitivitas, spesifisitas, NDP, NDN, RKP, dan RKN.Hasil: Proporsi pasien dengan status nutrisi baik, malnutrisi sedang, danmalnutrisi berat adalah17,4%, 64,2%, dan 18,4%. Titik potong optimal KGT pasien kanker lelaki dan perempuan berturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgfdengan sensitivitas 92,2% dan 73,9%, spesifisitas 54,6% dan 60,9%, NDP 92,2% dan 88,3%, NDN 54,6% dan 36,8%, RKP 2 dan 1,9, serta RKN 0,1 dan 0,4. Simpulan: Titik potong optimal KGT pasien kanker lelaki dan perempuanberturut-turut adalah ≤ 36,5 dan ≤ 21,5 kgf. Akurasi diagnostik KGT pasienkanker lelaki dan perempuan sebagai penapis malnutrisi berturut-turut dinilai baik dan sedang.ABSTRACT Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint and diagnostic accuracy of HGS were analyzed to generate sensitivity,specificity, PPV, NPV, LR+, and LR- .Result: The proportion of well nourished, moderately malnourished, and severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good.;Background: Malnutrition has a huge impact on cancer patients and therefore ithas to be evaluated using PG-SGA, but there are limitations such as the timeconsumingnature and the need of trained health personnels. Measurement ofHGS is faster and easier, but there is no sufficient information regarding its cutoffpointand diagnosticaccuracyfor cancerpatientsin Indonesia.Aim:defining cut-off point and diagnostic accuracy of HGS as a malnutritionscreening modality for outpatient cancer population at RSCM.Method: A cross-sectional study was conducted at RSCM oncology outpatientclinic from May 4th-October 1st, 2015. Subjects were 18-59 years old. Cut-offpoint and diagnostic accuracy of HGS were analyzed to generate sensitivity,specificity, PPV, NPV, LR+, and LR- .Result: The proportion of well nourished, moderately malnourished, and severelymalnourished subjects were 17.4%, 64.2%, and 18.4%, respectively. The optimalHGS cut-off point in male and female cancer patients were ≤ 36.5 and ≤ 21.5 kgfrespectively with sensitivity 92.2% and 73.9%, specificity 54.6% and 60.9%,, PPV92.2% and 88.3%, NPV 54.6% and 36.8%, LR+ 2 and 1.9, and LR- 0.1 and 0.4. Conclusion: The optimal HGS cut-off point in male and female cancer patientswere ≤ 36.5 and ≤ 21.5 kgf, respectively. Diagnostic accuracy of HGS as amalnutrition screening modality in male and female cancer patients were good and moderately good."

"ABSTRAKKasus kanker nasofaring memiliki banyak organ at risk diantaranya adalah parotid kanan, parotid kiri, mata kanan, mata kiri dan trakea.Teknik penyinaran yang dapat menekan dosis yang diterima organ at risk adalah volumetric modulation arc therapy VMAT . Dalam penelitian ini bertujuan untuk melakukan verifikasi dosis organ at risk pada kasus kanker nasofaring KNF menggunakan planning VMAT dengan teknik single arc dan double arc berdasarkan data klinis. Verifikasi ini dilakukan dengan menggunakan TLD rod dan film gafchromic EBT3 yang diletakkan pada pasien sesuai dengan letak organ at risk yang akan dievaluasi. Terdapat 5 organ at risk yang dievaluasi pada kasus kanker nasofaring diantaranya parotid kanan, parotid kiri, mata kanan, mata kiri dan trakea.Evaluasi yang dilakukan diantaranya perbandingan dosis antar teknik, deviasi pengukuran dosis menggunakan TLD rod dan film gafchromic EBT3 dengan TPS Treatment Planning System . Perbandingan pengukuran dosis rata-rata menggunakan film gafchromic, TLD rod dan TPS dapat dilihat bahwa nilai yang mendekati TPS adalah film gafchromic dengan nilai diferensiasi adalah 0,171 . Hasil pengukuran dosis menggunakan film gafchromic berdasarkan data CT rando dapat disimpulkan bahwa teknik VMAT double arc dengan kolimator dapat membuat organ at risk menjadi lebih aman karena dengan penggunaan kolimator dapat meminimalisasi kebocoran efek tongue and groove. Hasil statistik menggunakan perangkat lunak SPSS 16.0 didapat bahwa nilai uji korelasi antara 3 teknik double arc DA , double arc dengan kolimator DAC dan single arc SA menunjukkan korelasi kuat dan signifikan pada keseluruhan organ at risk kecuali parotis kiri pada teknik DA-DAC sedangkan pada teknik DAC-SA menunjukkan korelasi kuat dan tidak signifikan untuk keseluruhan organ at risk. Untuk uji hipotesa dapat disimpulkan bahwa perbedaan rata-rata distribusi dosis antara 3 teknik yang berbeda pada stadium 4 pada film gafchromic adalah signifikan.

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ABSTRACTThe cases of nasopharyngeal cancer have many organs at risk including right parotid, left parotid, right eye, left eye and trachea. The irradiation technique that can suppress the dose received by the organ at risk is volumetric modulation arc therapy VMAT . This research aims to verify dose in the organs at risk in cases of nasopharyngeal cancer NPC using VMAT planning with single arc and double arc techniques based on clinical data. The verification is performed by using TLD rod and gafchromic EBT3 films placed on the patient according to the location of the organs at risk which will be evaluated. There are 5 organs at risk evaluated in the cases of nasopharyngeal cancer such as right parotid, left parotid, right eye, left eye and trachea. The evaluation includes the ratio of dose between techniques, deviation of dose measurement using TLD rod and gafchromic EBT3 films with TPS Treatment Planning System . The measurement ratio of mean dose using gafchromic film, TLD rod and TPS shows that the values close to TPS is gafchromic film detector which its differentiation value is 0.171 . The result of dose measurement using gafchromic film based on the data of CT rando can be concluded that double arc VMAT technique with collimator can reduce the dose in the organ at risk. The statistical result using SPSS 16.0 shows that the correlation test value between 3 techniques such as double arc DA , double arc with collimator DAC and single arc SA shows strong and significant correlation in the whole organ at rialexcept left parotid in the DA DAC technique while in the DAC SA technique shows strong and insignificant correlation in the whole organ at risk. For hypothesis test, it can be concluded that the difference in themean dose distribution between 3 different techniques at stage 4 in gafchromic film is significant."

"Pada penderita kanker paru terjadi inflamasi sistemik dan dapat dilihat dengan peningkatan rasio netrofil limfosit di mana pemeriksaan ini lazim dilakukan di Rumah Sakit. Inflamasi sitemik dapat menyebabkan anoreksi sehingga asupan pada penderita kanker paru menurun dan memengaruhi status gizinya. Kejadian malnutrisi yang tinggi pada pasien paru dapat berakibat lamanya rawat inap, turunnya kualitas hidup, dan dapat memengaruhi keberhasilan terapi kanker sehingga terapi nutrisi yang cepat dan tepat sangat perlu dilakukan. Salah satu diagnostik status gizi pada penderita kanker yaitu dengan menggunakan kriteria ASPEN yang terdiri dari penurunan asupan, penurunan berat badan, penurunan massa otot dan massa lemak subkutan, akumulasi cairan general atau lokal, dan kapasitas fungsional. Dikatakan malnutrisi jika terdapat dua dari enam kriteria tersebut. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui hubungan status gizi dengan rasio netrofil limfosit pada pasien kanker paru di RSUP Persahabatan. Data diambil dari wawancara, pemeriksaan fisis, pemeriksaan laboratorium, dan rekam medis pasien poliklinik onkologi RSUP Persahabatan (n =52). Pada penelitian ini subjek sebagian besar berjenis laki-laki (61,5%), rentang usia terbanyak antara 50-60 tahun (38,5%), memiliki riwayat merokok (55,8%) dengan indeks Brinkman berat (30,8%). Lebih dari 50% subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Sebagian besar subjek penelitian berisiko malnutrisi atau malnutrisi sedang (38,5%) dan sebanyak 67,3% mengalami malnutrisi. Pada penelitian ini subjek dengan nilai rasio netrofil limfosit tinggi sebanyak 38,5% dan rendah sebanyak 61,5%. Tidak terdapat hubungan antara status gizi dengan rasio netrofil limfosit pada penelitian ini (p = 0,35).

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Systemic inflammation in patients with lung cancer can be seen by the increase in the neutrophil lymphocyte ratio where these examinations are common in hospitals. Systemic inflammation can cause anorexia, with the result that nutrition intake of lung cancer patients decreases and affects their nutritional status. High incidence of malnutrition in lung cancer patients can result in length of stay, decreased quality of life, and can affect the treatment of cancer therapy, therefore prompt and appropriate nutritional therapy is essential. One of the diagnostics of nutritional status for lung cancer patients is by using the ASPEN criteria which consist of decreased nutritional intake, weight loss, decreased muscle mass and subcutaneous fat mass, general or local fluid accumulation, and functional capacity. Malnutrition can be seen if there are two of the six criteria. This study is a cross-sectional study which aimed to determine the association between nutritional status and the ratio of lymphocyte neutrophils in lung cancer patients at Persahabatan Hospital. Data were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology polyclinic of Persahabatan Hospital (n = 52). The subjects of the study were mostly male (61.5%), the largest age range was between 50-60 years (38.5%), had a history of smoking (55.8%) with a severe Brinkman index (30.8%). More than 50% of the subjects with energy and protein intake were below the recommended intake for cancer patients. Most of the study subjects were at risk of malnutrition or moderate malnutrition (38.5%) and 67.3% of them were experiencing malnutrition. The subjects with the highest neutrophil lymphocyte ratio value were 38.5% and the lowest value were 61.5%. Overall, there was no relationship between nutritional status and the ratio of neutrophil to lymphocytes in this study (p = 0.35)."

"Malnutrisi pada kanker nasofaring (KNF) disebabkan oleh peradangan, sel tumor dan efek kemoradioterapi. Malnutrisi dikaitkan dengan penurunan kualitas hidup, fungsi fisik, dan kelangsungan hidup. Pemberian nutrisi pasien KNF yang menjalani radioterapi (RT) memperbaiki status gizi, kapasitas fungsional, dan prognosis keseluruhan. Pasien KNF dengan kaheksia, usia 29 - 67 tahun, tiga pria dan satu wanita yang menjalani kemoradioterapi. Diberikan nutrisi sesuai kebutuhan energi, makronutrien, mikronutrien, dan nutrien spesifik. Pemantauan pasien di awal, hingga RT selesai, pada keluhan terkait terapi, analisis asupan, antropometri, komposisi tubuh, kapasitas fungsional, dan pemeriksaan CRP. Didapatkan penurunan asupan pada empat pasien saat RT, tetapi meningkat lagi pada tiga pasien setelah pemasangan NGT. Satu pasien dengan peningkatan berat badan (BB), sedangkan 3 pasien lainnya BB menurun 2,2-13% pasca RT. Tiga pasien dengan CRP meningkat pada awal RT, tetapi hanya 1 pasien dengan CRP kembali normal. Massa otot meningkat pada 3 pasien setelah RT. Tiga pasien mengalami perbaikan skor ECOG pasca RT, dan satu pasien dengan skor ECOG tetap stabil. Pemasangan NGT dapat mempertahankan asupan pasien. Terapi nutrisi memperbaiki penurunan BB, tetapi tidak terlihat kaitan dengan CRP, massa otot dan kapasitas fungsional karena faktor lain.

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Malnutrition in nasopharyngeal carcinoma (NPC) is induced by inflammation, tumor cells and the effects of chemoradiotherapy. Malnutrition is associated with decrease in quality of life, physical function and survival. Nutritional therapy to NPC who underwent radiotherapy (RT) improves nutritional status, functional capacity, and prognosis. NPC cachexic patients, ages 29 - 67 years, three male and one female, all underwent chemoradiotherapy. Nutrition therapy start with planning of energy, macronutrient, micronutrient and specific nutrients needs. Patients monitoring start from the the beginning, until completed RT, related to therapy, intake analysis, anthropometry, body composition, functional capacity, and C-Reactive Protein (CRP) examination. Decrease intake in four patients during RT, but it increased in three patients after NGT insertion. One patient increase body weight (BW), while other 3 patients dropped BW 2.2-13% post-RT. Three patients increase in CRP at the start of RT, but only 1 CRP patient returned to normal. Muscle mass increased in 3 patients after RT. Three patients had improved ECOG scores after RT, and one patient with ECOG scores remained stable. Insertion of NGT can maintain patient intake. Nutritional therapy maintains BW, but does not appear to be related to CRP, muscle mass and functional capacity due to other factors."

"Pasien rawat inap di rumah sakit dengan keganasan sering terjadi malnutrisi. Deteksi dini malnutrisi mempercepat terapi awal nutrisi sehingga mengurangi morbiditas dan mortalitas. Penelitian ini merupakan studi uji diagnostik membandingkan MST dan PG-SGA dengan SGA pada pasien kanker ginekologik rawat inap di RSUPN Cipto Mangunkusumo sebanyak 66 orang pada bulan April 2015. Pengumpulan data menggunakan formulir skrining, pemeriksaan fisik, dan pengukuran antropometri. MST memiliki sensitivitas 70%, spesifisitas 88%, PPV 90%, NPV 65%, AUC 0,79. PG-SGA mempunyai sensitivitas 100%, spesifisitas 92%, PPV 95%, NPV 100%, AUC 0,96. Terdapat perbedaan signifikan lama waktu pengerjaan di antara ketiganya, dengan waktu tercepat dimiliki oleh MST. Prevalensi malnutrisi berdasarkan SGA sebesar 60,6%. PG-SGA merupakan alat skrining yang sesuai dalam mendeteksi malnutrisi pasien kanker ginekologik rawat inap.

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Malnutrition is a common problem in hospitalized patients with malignancies. Early recognition of malnutrition leads to appropriate nutritional care plans and reduces rate of both morbidity and mortality. This diagnostic test study which comparing between MST and PG-SGA against SGA, was conducted on 66 hospitalized gynecologic cancer patients in April 2015. Data collection was obtained using screening tool forms, physical examination, and anthropometric measurement. According to SGA, 60.6% of patients were malnourished. MST had a sensitivity of 70% and a specificity of 88%. The PPV of MST was 90%, NPV 65%, and AUC value was 0.79. PG-SGA had a sensitivity of 100% and a specificity of 92%. The PPV of PG-SGA was 95%, NPV 100%, and AUC value was 0.96. There were a significant difference in time spent applying questionnaires between these screening tools, and MST had the quickest among three. PG-SGA is suitable screening tool for detecting risk of malnutrition in hospitalized patients with gynecologic cancer."

"Malnutrisi sering dialami oleh pasien kanker dan dapat menyebabkan penurunan kualitas hidup. Oleh karena itu, identifikasi awal pasien yang berisiko malnutrisi harus dilakukan pada semua pasien kanker, namun hingga saat ini, belum ada baku emas alat skrining yang digunakan di bagian rawat jalan radioterapi. Penelitian ini merupakan studi potong lintang yang dilakukan untuk membandingkan skrining malnutrisi Malnutrition Screening Tool (MST) dan Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) pada 144 pasien kanker yang akan menjalankan radioterapi di RSUPNCM, dengan Patient- Generated Subjective Global Assessment (PG-SGA) sebagai baku emas. Didapati sebanyak 41% pasien berisiko malnutrisi (PG-SGA). Skrining MST dinilai mudah dan cepat dengan rerata waktu pengerjaan 21 detik, dan memiliki nilai sensitivitas 84,75%, spesifisitas 77,65%, nilai prediksi positif (NPP) 0,73, nilai prediksi negatif (NPN) 0,88, dan nilai area under the ROC curve (AUC) 0,812. Skrining abPG-SGA memiliki sensitivitas 98,31%, spesifisitas 92,94%, NPP 0,91, NPN 0,99, AUC 0,956, dan rerata waktu pengerjaan 2 menit 24 detik. Kesimpulan yang dapat diambil adalah abPG-SGA merupakan alat skrining yang lebih baik dan akurat untuk digunakan di bagian rawat jalan radioterapi.

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Malnutrition is common among cancer patients and can lead to decreased quality of life. Therefore, early identification of patients at risk of malnutrition should be performed in all cancer patients, but until now, there is no gold standard of nutrition screening tool that should be used in outpatient radiotherapy setting. This study was a cross-sectional study conducted to compare Malnutrition Screening Tool (MST) and Abridged Patient-Generated Subjective Global Assessment (abPG-SGA) as nutrition screening tools in 144 radiotherapy outpatients against Patient-Generated Subjective Global Assessment (PG-SGA) as the gold standard. Forty-one percent of patients were at risk of malnutrition (PG- SGA). The MST was a simple and quick tool with an average of 21 seconds. It had 84.75% sensitivity, 77.65% specificity, positive predictive value (PPV)=0.73, negative predictive value (NPV)=0.88, and area under the ROC curve (AUC)=0.812. The abPG-SGA yielded 98.31% sensitivity, 92.94% specificity, PPV=0.91, NPV=0.99, AUC=0.956, and it took an average of 2 minutes 24 seconds. In conclusion, the abPG-SGA is a better and more accurate screening tool in outpatient radiotherapy setting."

"Malnutrisi sering pada karsinoma hepatoselular (KHS), diakibatkan oleh anoreksia, penurunan asupan serta keadaan katabolik. Serial kasus bertujuan memberikan terapi gizi guna proses penyembuhan dan memperbaiki kualitas hidup. Empat orang pasien berusia 42–67 tahun, dengan KHS, penurunan berat badan 14,3–29,6% selama dua bulan hingga satu tahun. Tiga orang pro reseksi dan satu orang mendapat terapi paliatif dengan kanker kaheksia. Pemberian nutrisi disesuaikan keadaan klinis. Kebutuhan kalori berdasarkan Harris-Benedict. Sebelum pembedahan kebutuhan kalori total tercapai Setelah pembedahan, toleransi asupan baik, nutrisi ditingkatkan bertahap. Saat pulang keadaan umum stabil, kapasitas fungsional membaik, luka operasi baik.

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Malnutrition is common in hepatocellular carcinoma (HCC), caused by anorexia, decreased intake and catabolic state. The aim of this case series provide nutrition therapy to support the healing process and to improve quality of life. Patients were four people, age between 42–67 years, with HCC, weight loss 14,3–29,6 % for two months to one year. Three people with pro resection and one person had palliative therapy and cachexia cancer. Nutrition was given according to clinical state. Calorie requirement was based on Harris-Benedict. Total calorie needs was achieved prior to surgery, and good tolerance intake after surgery, nutrition enhanced gradually. Patients discharge from hospital with stable general condition, improved functional capacity, and good surgical wound healing."

"Kanker nasofaring (KNF) merupakan kanker leher kepala terbanyak di Indonesia (28,4%) dan sebagian besar terdiagnosis pada stadium lanjut. Modalitas pengobatan pada kasus KNF stadium lanjut adalah kemoterapi dan radioterapi. Namun, pada stadium sama, respon terhadap pengobatan memiliki hasil berbeda dikarenakan adanya perbedaan karakteristik biologi molekular. Cyclin D1 adalah protein yang berperan dalam siklus sel. Peningkatan ekspresi cyclin D1 akan mempercepat proliferasi. Penelitian ini ingin mengetaui tingkat ekspresi cyclin D1 terhadap respons kemoterapi. Hal tersebut berdasarkan perbedaan hasil penelitian terdahulu. Data ekspresi cyclin D1 pada KNF di Indonesia belum ada, sehingga perlu penelitian ekspresi cyclin D1 pada KNF serta hubungannya berdasarkan respons pengobatan. Metode: Penelitian ini menggunakan studi kohort retrospektif dengan subjek merupakan pasien KNF yang berobat di RSCM pada kurun waktu 2015-2018. Gambaran radiologi sebelum dan sesudah pengobatan ditinjau ulang berdasarkan kriteria RECIST. Pewarnaan imunohistokimmia cyclin D1 menggunakan antibodi monoklonal cyclin D1 NovocastraTM dengan teknik pengambilan antigen suhu tinggi dan intensitasnya dinilai dengan H-skor menurut kriteria Allred. Hasil: Terdapat 16 subjek (51,6%) dengan ekspresi cyclin D1 positif dan 15 subjek (48,4%) dengan ekspresi negatif. Peneliti menemukan bahwa ekspresi cyclin memiliki perbedaan rerata yang bermakna antara kelompok subjek yang respons (rerata 116,24 ± 57,80) dan tidak respons (rerata 77,97 ± 45,27) terhadap pengobatan (p = 0,048). Simpulan: Penelitian ini menunjukkan ekspresi cyclin D1 yang kuat pada kelompok dengan respons pengobatan yang baik.

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Nasopharyngeal cancer (NPC) is the most type of head and neck cancer in Indonesia (28.4%) and mostly diagnosed at advanced stage. Treatment of this stage is chemotherapy and radiotherapy. However, patients with the same stage of disease had different treatment response probably due to different characteristics of molecular biology. Cyclin D1 is a protein involved in cell cycle, which the overexpression of it will fasten proliferation. Studies regarding the association of cyclin D1 expression and chemotherapy response have shown a different result. In Indonesia, data of cyclin D1 expression of NPC do not yet exist. This study aimed to examine the proportion of cyclin D1 in NPC and its association with treatment response. Methods: A retrospective cohort study was conducted using subjects of NPC patients at Cipto Mangunkusumo Hospital from 2015 until 2018. The response of treatment was reviewed based on RECIST criteria. The technique used for cyclin D1 immunohistochemistry staining was antigen retrieval methods, using cyclin D1 NovocastraTM monoclonal antibody and the intensity was assessed based on Allred criteria. Results: Sixteen subjects (51.6%) had positive expression of cyclin D1 and 15 subjects (48.4%) had negative expression. The researchers found that cyclin D1 expression had significant mean differences between groups of subjects who responded (mean ± SD = 116.24 ± 57.80) and did not respond (mean ± SD = 77.97 ± 45.27) to treatment (p = 0.048). Conclusion: This study suggests that higher expression of cyclin D1 is associated with a good treatment response in NPC patients."