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Hubungan Kadar Laminin Serum dengan Tingkat Kesadaran Menurut Skor FOUR pada Pasien Cedera Otak Akibat Trauma Putera, Akbar S.; Prasetyo, Eko; Oley, Maximillian Ch.; Langi, Fima L. F. G.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.35901

Abstract: Traumatic brain injury (TBI) could result in disorders of central nervous system (CNS). Serum laminin level and the FOUR score have both been suggested as predictors for the outcomes after TBI. This study was aimed to evaluate the relationship between serum laminin level and the FOUR score in TBI patients. This was an observational and analytical study with a cross-sectional design. Subjects were 32 patients with TBI and FOUR scores of 0-16 admitted at the Emergency Surgery Installation of Prof. Dr. R. D. Kandou Hospital. Venous blood sample for laminin was taken less than 24 hours after trauma. Assessment of the level of consciousness was determined by using the FOUR score at Emergency Surgery Installation admission <24 hours and observation after >24 hours. Proportional regression model was used to assess changes in FOUR score associated with laminin level. The results obtained 32 patients with TBI, mean laminin level was 818.4 pg/mL with range IQR 597.4-1235.4 pg/mL. In final regression model, each increase of one unit of pre-24 hours FOUR score decreased serum laminin level by 54.4 pg/mL (95% CI -76.3; 32.1 pg/mL, p<0.001). Same as the relationship occurred for the FOUR score after 24 hours, but the decrease was slightly smaller, at 37.2 pg/mL (95% CI -50.2; -24.3 pg/mL, p<0.001). FOUR scores with a high risk of mortality were more likely to be found in relatively high serum laminin levels. In conclusion, there is a relationship between serum laminin level and the FOUR score. Increase in serum laminin level is a potential alternative to lower FOUR score and to predictof poorer outcome in patient with TBI.Keywords: laminin; FOUR score; traumatic brain injury (TBI)Â Abstrak: Pada cedera otak akibat trauma (COT) sering terjadi gangguan saraf pusat. Laminin serum dan skor FOUR disarankan sebagai prediktor luaran setelah COT. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar laminin serum dan skor FOUR pada pasien COT. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Penelitian dilaksanakan pada 32 pasien dengan COT dan skor FOUR 0-16 yang masuk ke Instalasi Rawat Darurat Bedah (IRDB) RSUP Prof. Dr.R. D. Kandou, Manado. Sampel darah vena untuk pemeriksaan serum laminin diambil kurang dari 24 jam setelah trauma. Penilaian tingkat kesadaran ditetapkan dengan skor FOUR saat masuk IRDB <24 jam dan observasi setelah >24 jam. Model regresi proporsional digunakan untuk menilai hubungan kadar laminin serum dengan skor FOUR. Hasil penelitian mendapatkan 32 pasien dengan COT. Rerata kadar laminin serum 818,4 pg/mL dengan range IQR 597,4-1.235,4 pg/mL. Pada model regresi akhir, setiap peningkatan satu unit skor FOUR pra 24 jam rata-rata menurunkan kadar laminin serum sebesar 54,4 pg/mL (95% CI -76,3; 32,1 pg/mL, p<0,001). Hubungan sejenis terjadi untuk skor FOUR pasca 24 jam, tetapi nilai penurunannya sedikit lebih kecil, yakni 37,2 pg/mL (95% CI -50,2; -24,3 pg/mL, p<0,001). Skor FOUR dengan risiko mortalitas tinggi lebih cenderung ditemukan pada kadar laminin serum relatif tinggi. Simpulan penelitian ini ialah terdapat hubungan antara kadar laminin serum dengan skor FOUR. Peningkatan kadar laminin serum merupakan alternatif potensial skor FOUR yang lebih rendah untuk memrediksi luaran yang lebih buruk pada pasien COT.Kata kunci: laminin; skor FOUR; cedera otak akibat trauma (COT)

Hubungan Kadar Interleukin-10 Serum dan Kadar Leukosit Darah Perifer pada Pasien Cedera Otak Berat Akibat Trauma Suyanto, Edih; Prasetyo, Eko; Oley, Maximillian Ch.
Jurnal Biomedik : JBM Vol 10, No 2 (2018): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.10.2.2018.20090

Abstract: This study was aimed to prove that in severe traumatic brain injury (TBI) there was an elevation in serum IL-10 level as well as in peripheral blood leukocyte level, and a correlation between both of them. This was an analytical correlational study. All patients had IL-10 level above normal value (18 pg/ml). There were three patients with normal blood leukocyte level. The correlation between IL-10 and blood leukocyte level was tested by using simple linear regression analysis and Pearson correlation coefficient analysis which obtained r = 0.045 with a P of 0.426 (>0.05). These results indicated a positive relationship between IL-10 and leukocytes levels, but not statistically significant. Conclusion: Interleukin-10 was consistantly elevated following severe traumatic brain injury and was a better TBI biomarker than the peripheral leukocyte level.Keywords: IL-10, leukocytes, TBIAbstrak: Penelitian ini bertujuan untuk membuktikan bahwa pada cedera otak akibat trauma (COT) berat terdapat peningkatan kadar serum IL-10 dan kadar leukosit darah perifer serta korelasi antara keduanya. Jenis penelitian ini ialah analitik korelasional. Hasil penelitian mendapatkan 20 pasien dengan COT berat berusia 16-65 tahun. Semua pasien memperlihatkan kadar Il-10 di atas nilai normal (18 pg/ml). Terdapat 3 pasien dengan kadar leukosit dalam batas normal Hubungan antara IL-10 dan leukosit diuji dengan analisis regresi linier sederhana dan analisis koefisien korelasi Pearson dan mendapatkan r = 0,045 dengan P = 0,426. Hasil ini menunjukkan hubungan positif antara IL-10 dan leukosit, tetapi tidak bermakna secara statistik (P = 0,426 >0,05). Simpulan: IL-10 secara konsisten meningkat setelah COT dan sebagai biomarker COT yang lebih baik daripada leukosit perifer.Kata kunci: IL-10, leukosit, COT

Efek terapi oksigen hiperbarik terhadap nilai Montreal Cognitive Assesment Indonesia (MoCA-INA) pada pasien cedera otak traumatik ringan Sagay, Leonardo V.; Oley, Maximillian Ch.; Hatibie, Mendy J.; Prasetyo, Eko; Langi, Filma L. F. G.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.35947

Abstract: Hyperbaric oxygen therapy (HBOT) uses 100% oxygen at a pressure of more than 1 ATM in a chamber, therefore, it can improve the state of tissue hypoxia. This study was aimed to prove that TOHB could increase the MoCA-INA score in mild traumatic brain injury (mTBI). This study was carried out at the Surgery Department of Prof. Dr. R. D. Kandou Hospital, Manado using the pre and post trial design. Subjects were 20 patients with mTBI divided into two groups: treated with HBOT and control group (without HBOT). Each patient involved would be examined for MoCA-INA before and after treatment or with HBOT added. The results showed that before treatment, the MoCA-INA scores tended to be evenly distributed around 36 (SD 5). The score increased to 71 (SD 10) at post-injury management or a mean increase of 35 points (p<0.001 in the paired two-sample t-test). However, there was no significat difference in MoCA-INA scores between the first and the second measurements. The density of the two groups clearly overlapped even though the variation of MoCA-INA scores of the HBOT group was much wider than that of the control group (p=0.302 and 0.297 in the first and second measurements, respectively). There was no cognitive disturbance either mild, moderate, or severe in all patients. In conclusion, there was an increase of the MoCA-INA value in mTBI patients after treatment. The patients treated with HBOT showed wider variation of MoCA-INA score of pre and post HBOT than those without HBOT Keywords: HBOT; mTBI; MoCA-INA; cognitive functionÂ Abstrak: Terapi oksigen hiperbarik (TOHB) menggunakan oksigen 100% pada tekanan lebih dari 1 ATM dalam sebuah chamber sehingga dapat memperbaiki keadaan hipoksia jaringan. Penelitian ini bertujuan untuk membuktikan bahwa TOHB dapat meningkatkan nilai MoCA-INA pada pasien cedera otak traumatik ringan (COTr). Penelitian dilaksanakan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou, Manado dengan menggunakan pre and posttrial design. Subyek penelitian ialah 20 pasien COTr dibagi dalam dua kelompok: dengan dan tanpa TOHB (kelompok kontrol). Setiap subyek diperiksa MoCA-INA sebelum dan sesudah penatalaksanaan cedera/disertai TOHB. Sebelum penatalaksanaan cedera, rerata skor MoCA-INA sekitar 36 (SD 5) dan nilai tersebut meningkat menjadi 71 (SD 10) pasca penatalaksanaan cedera atau kenaikan rerata 35 poin (p<0,001 pada uji t dua sampel berpasangan). Tidak tampak perbedaan skor MoCA-INA baik pada pengukuran pertama maupun kedua. Densitas kedua kelompok terlihat jelas tumpang tindih sekalipun variasi skor MoCA-INA group TOHB jauh lebih lebar daripada group kontrol (p=0,302 dan 0,297 masing-masing pada pengukuran pertama dan kedua). Tidak terlihat adanya gangguan kognitif ringan sedang maupun berat pada semua pasien. Simpulan penelitian ini ialah terdapat peningkatan nilai MoCA-INA pada pasien COTr. Pasien dengan TOHB memperlihatkan variasi skor MoCA-INA yang lebih besar pada pre dan pasca TOHB.Kata kunci: TOHB; COT; MoCA-INA; gangguan kognitif

Graft Tulang Alveolar dan Pemberian Terapi Oksigen Hiperbarik pada Gnatoschizis: Laporan Kasus Limarga, Nidia; Hatibie, Mendy; Oley, Maximillian Ch.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.36877

Abstract: Gnatoschizis is a congenital disorder due to complex causes involving many genetic and environmental factors. The shape and complexity of the cleft varies greatly, which will determine the final outcome of the reconstruction. The management involves a multidisciplinary approach including orthodontics, prosthodontics, as well as speech and psychological therapist. Bone grafting materials such as iliac crest (corticocancellous autogenous), bone morphogenetic proteins and recombinant human proteins have shown good long-term results. An additional method that is considered effective in accelerating bone growth is the administration of hyperbaric oxygen therapy (HBOT) which has been reported to increase the accumulation of minerals needed for osteogenesis, such as calcium, magnesium, and phosphorous. We reported a case of a 14-year-old girl with gnatoschizis who underwent an alveolar bone graft surgery and one day after the operation was immediately followed by administration of (HBOT) to improve the bone healing process. cleft location. Autogenous iliac bone graft was used for closure of the bony defect at the site of the cleft. Follow up at day-14 showed a satisfying result. In conclusion, in this patient continuity of upper dental arch was achieved as well as optimal alar basis, no fistula, stabile upper dental arch for orthodontic treatment, and ideal alveolar morphology that supported the ultimate goal of cleft palate treatment - improvement of quality of life.Keywords: gnatoschizis; alveolar bone graft; hyperbaric oxygen therapyÂ Â Abstrak: Gnatoschizis merupakan kelainan kongenital dengan penyebab kompleks yang meli-batkan banyak faktor genetik dan lingkungan. Bentuk dan kompleksitas sumbing sangat bervariasi, yang akan menentukan hasil akhir rekonstruksi. Tatalaksananya melibatkan pendekatan multi-disiplin termasuk ortodontik, prostodontik, serta terapi wicara dan psikologis. Bahan pencang-kokan tulang seperti krista iliaka (corticocancellous autogenous), protein morfogenetik tulang dan protein manusia rekombinan telah menunjukkan hasil jangka panjang yang baik. Salah satu metode tambahan yang dianggap efektif mempercepat pertumbuhan tulang ialah pemberian terapi oksigen hiperbarik (TOHB) yang telah dilaporkan meningkatkan akumulasi mineral yang dibutuh-kan untuk osteogenesis, seperti kalsium, magnesium, dan fosfor. Kami melaporkan kasus seorang anak perempuan berusia 14 tahun dengan gnatoschizis yang menjalani operasi cangkok tulang alveolar dan satu hari setelah operasi langsung dilanjutkan pemberian TOHB untuk meningkatkan proses penyembuhan tulang. Cangkok tulang iliaka autogenous digunakan untuk penutupan defek tulang di lokasi sumbing. Follow up pada hari ke 14 di poliklinik dengan pemeriksaan fisik pada defek lokasi sumbing mendapatkan hasil yang memuaskan. Simpulan laporan kasus ialah pada pasien ini diperoleh kontinuitas lengkung rahang atas, basis alar yang optimal, fistula dihilangkan, segmen rahang atas yang stabil untuk perawatan ortodontik, dan morfologi alveolar yang ideal yang menyokong tujuan akhir tatalaksana sumbing yaitu perbaikan kualitas hidup.Kata kunci: gnatoschizis; cangkok tulang alveolar; terapi oksigen hiperbarik

Terapi Oksigen Hiperbarik Meningkatkan Kualitas Hidup Pasien Glioblastoma Multiforme Stadium Akhir Dinilai Berdasarkan Neurologic Assessment Neuro Oncology Score Djunadi, Hanni; Oley, Maximillian Ch.; Prasetyo, Eko; Hatibie, Mendy; Langi, Fredrik G.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.37098

Abstract: Patients with end-stage glioblastoma multiforme (GBM) that cannot be operated or treated with chemotheraphy and radiotheraphy have increased clinical complaints, thus affecting the patientsâ€™ quality of lifes (QoL). Hyperbaric oxygen therapy (HBOT) could alters hypoxic condition in tumor tissue with a different cascade from wound healing process. This study was aimed to assess whether the QoL of end-stage GBM patients could improve with the administration of HBOT assessed by decreased clinical complaints based on NANO score. The study was carried out at the Surgery Department of Prof. Dr. R. D. Kandou Hospital Manado, using pre and posttrial design. Each sample was assessed for the NANO score before HBOT, after one time, three times, five times, and 10 times of HBOT. The results showed that there was a change in the NANO score before and after 10 times of HBOT. The decrease in the NANO score occurred more quickly after the therapy. In the last two measurements, the NANO score according to the RVC model decreased from one to two units. The decreased NANO score occurred quite regularly with variations in the score that changed from time to time. In conclusion, HBOT can improve the QoL of patients with end-stage GBM and reduce the NANO score which is an assessment of clinical complaints of the patients.Keywords: glioblastoma multiforme; hyperbaric oxygen therapy; NANO scoreÂ Abstrak: Penderita glioblastoma multiforme (GBM) stadium akhir yang tidak dapat dilakukan operasi, kemoterapi dan radioterapi memiliki keluhan klinis yang semakin meningkat sehingga memengaruhi kualitas hidup. Terapi oksigen hiperbarik (TOHB) dapat mengubah kondisi hipoksia pada jaringan tumor dengan kaskade yang berbeda dari proses penyembuhan luka. Penelitian ini bertujuan untuk menilai apakah kualitas hidup pasien GBM stadium akhir dapat membaik dengan pemberian TOHB, dinilai dengan menurunnya keluhan klinis berdasarkan NANO score. Penelitian dilakukan di Bagian Bedah RSUP Prof. Dr. R. D. Kandou Manado, dengan menggunakan pre and posttrial design. Pada setiap sampel dilakukan penilaian NANO score sebelum TOHB, setelah satu kali, tiga kali, lima kali, dan 10 kali TOHB. Hasil penelitian mendapatkan adanya perubahan NANO score sebelum TOHB dan setelah 10 kali TOHB. Penurunan NANO score berlangsung lebih cepat pasca terapi tersebut. Dalam dua pengukuran terakhir, NANO score menurut model RVC turun dari satu hingga dua satuan. Pada grafik, hasil penurunan NANO score terjadi cukup beraturan dengan variasi score yang berubah dari waktu ke waktu. Simpulan penelitian ini ialah TOHB dapat meningkatkan kualitas hidup penderita GBM stadium akhir dan menurunkan NANO score yang menjadi penilainan keluhan klinis penderita.Kata kunci: glioblastoma multiforme; terapi oksigen hiperbarik; NANO score

Evaluasi Hasil Labioplasti Menggunakan Skor CLEFT-Q Deki, Feldy; Hatibie, Mendy; Oley, Maximillian Ch.; Langi, Fredrik G.
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.35939

Abstract: Application of CLEFT-Q score instrument in the assessment of surgical outcomes for cleft lip and/or cleft palate based on patient reports is still relatively new. This study was aimed to establish the normative value of the Indonesian version of CLEFT-Q score in post-cleft lip surgery patients and to differentiate the results of cleft lip surgery according to the score based on the type of cleft, age, and sex. This was a preliminary study using the Indonesian CLEFT-Q instrument. Patients were interviewed for filling out the Indonesian version of CLEFT-Q after surgery. There were 75 samples in this study. Significant results were found in the association between age and CLEFT-Q score (p<0.05 and R>0.35). Variable selection for multi-variable analysis included cleft type and age in the model, where age alone indicated a significant relationship. The linear regression model involved the relationship between CLEFT-Q scores and gender, age, and cleft type as covariates. The correlation shown was classified as having moderate strength (R=0.46) for all covariates. In conclusion, the normative value of the Indonesian version of CLEFT-Q score with an approach to post-cleft lip surgery patients got a value that was in accordance with the highest standard in the literature, namely 91. The results of cleft lip surgery according to the Indonesian version of CLEFT-Q score based on the type of cleft, age and gender can be applied according to the literature.Keywords: cleft lip; cleft palate; cleft lip and palate; Indonesian version of CLEFT-QÂ Abstrak: Penerapan skor CLEFT-Q dalam penilaian luaran operasi bibir sumbing dan/atau langit-langit terbelah berdasarkan laporan pasien masih relatif baru. Penelitian ini bertujuan untuk mene-gakkan nilai normatif skor CLEFT-Q berbahasa Indonesia pada pasien pasca operasi bibir sum-bing serta membedakan hasil operasi bibir sumbing menurut skor tersebut berdasarkan tipe cleft, usia, dan jenis kelamin. Jenis penelitian ialah studi pendahuluan penggunaan CLEFT-Q berbahasa Indonesia. Pasien diwawancarai untuk melakukan pengisian CLEFT-Q berbahasa Indonesia setelah operasi. Hasil penelitian mendapatkan total 75 sampel. Hasil bermakna ditemukan pada hubungan antara usia dan skor CLEFT-Q (p <0,05 dan R > 0,35). Seleksi variabel untuk analisis multivariabel mengikutsertakan tipe cleft dan usia di dalam model, dan variabel usia saja yang mengindikasikan adanya hubungan bermakna (95% CI 1,15-2,33; p=0,006). Model regresi linear melibatkan hubungan antara skor CLEFT-Q dengan jenis kelamin, usia, dan tipe cleft sebagai kovariat dan mendapatkan korelasi kekuatan sedang (R=0,46) untuk semua kovariat. Simpulan penelitian ini ialah nilai normatif skor CLEFT-Q berbahasa Indonesia dengan pendekatan terhadap pasien pasca operasi bibir sumbing mendapatkan nilai yang sesuai dengan standar tertinggi pada kepustakaan yaitu 91. Hasil operasi bibir sumbing menurut skor CLEFT-Q berbahasa Indonesia berdasarkan tipe cleft, umur dan jenis kelamin dapat diterapkan sesuai kepustakaan.Kata kunci: cleft lip; cleft palate; cleft lip and palate; skor CLEFT-Q berbahasa Indonesia

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