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Heber B. Sapan, Heber B.
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Biochemistry, Genetics & Molecular Biology Health Professions

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Perbandingan indeks massa tubuh, lingkar pinggang, dan rasio pinggang pinggul sebagai faktor risiko kanker kolorektal Khosama, Yuansun; Sapan, Heber B.; Panelewen, Jimmy; Kalesaran, Laurens T. B.
Jurnal Biomedik : JBM Vol 8, No 2 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.2.2016.12670

Abstract

Abstract: Globally, colorectal cancer is the 4th cause of deaths. Risk factors of colorectal cancer are divided into modified and unmodified; obesity is one of the modified factors. It is accepted that insulin resistance and metabolic dysfunction act as a link between obesity and colorectal cancer. Distribution of fat tissue in Asian including Indonesian differs from that in Western people. Although of the same body mass index (BMI), Asian have higher fat tissue level than the Westerns. Body fat tissue can be measured by using BMI, waist circumference (WC), and waist-hip ratio (WHR). Acurate anthropometric measurements play some important roles in prevention of colorectal cancer. This study aimed to compare the three anthropometric parameters in colorectal cancer patients. This was a descriptive analytical study with a cross sectional design. Subjects were colorectal patients admitted to Surgery Department of Sam Ratulangi University Manado and its collaborationg hospitals from June 2015 to December 2015. There were 33 colorectal cancer patients in this study consisted of 22 males and 11 females. The ages ranged from 27 years to 77 years. The sensitivity result was as follows: BMI 33.3%, WC 51%, and WHR 42%, meanwhile the specifity result was 75.80%; 60.60%; and 60.60% respectively. The X2 test showed a P value of 0.327. Conclusion: Statistically, BMI, WC, and WHR showed no significant difference as the risk factors of colorectal cancer. However, the three parameters have to be used together to detect the accumulation of body fat tissue. It is suggested that the detection has to be applied in primary health care to diminish the colorectal cancer risk.Keywords: colorectal cancer, BMI, WC, WHRAbstrak: Kanker kolorektal (KKR) merupakan penyebab kematian keempat terbanyak di dunia. Secara garis besar faktor risiko KKR terbagi atas yang tidak dapat dimodifikasi dan yang dapat dimodifikasi, salah satunya ialah obesitas. Resistensi insulin dan disfungsi metabolik menjadi penghubung antara obesitas dan karsinoma kolorektal. Distribusi lemak tubuh pada orang Asia, termasuk Indonesia, berbeda dengan distribusi lemak tubuh pada orang Barat. Pada indeks massa tubuh (IMT) yang sama, orang Asia memiliki kadar lemak tubuh yang lebih tinggi dibandingkan orang Barat. Kadar lemak tubuh dapat dinilai melalui pengukuran IMT, lingkar pinggang (LP), dan rasio pinggang-pinggul (RPP). Penelitian ini bertujuan untuk membandingkan ketiga parameter ukuran antropometri tubuh pada pasien KKR. Penentuan patokan antropometri tubuh yang tepat membantu tindakan preventif KKR. Jenis penelitian ialah deskriptif analitik dengan desain potong lintang. Subyek penelitian ialah pasien KKR yang dirawat di Bagian Bedah Fakultas Kedokteran Universitas Sam Ratulangi Manado dan RS jejaringnya sejak bulan Juni 2015-Desember 2015. Hasil penelitian mendapatkan 33 pasien KKR (22 laki-laki dan 11 perempuan). Usia pasien berkisar 27-77 tahun. Sensitivitas IMT ialah 33,3%; LP 51%; dan RPP 42%, sedangkan spesifisitas berturut-turut ialah 75,80%; 60,60%; dan 60,60%. Uji X2 mendapatkan nilai P = 0,327. Simpulan: IMT, LP, dan RPP secara statistik tidak menunjukkan perbedaan bermakna sebagai faktor risiko KKR. Ketiganya harus diukur bersama-sama untuk mendeteksi akumulasi lemak tubuh. Disarankan deteksi harus dimulai di pelayanan primer untuk mengurangi risiko KKR.Kata kunci: KKR, IMT, LP, RPP
Pola kuman dari infeksi luka operasi pada pasien multitrauma Barung, Sidhit; Sapan, Heber B.; Sumanti, Winfrid M.; Tubagus, Rudy
Jurnal Biomedik : JBM Vol 9, No 2 (2017): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.9.2.2017.16360

Abstract

Abstract: Surgical site infection (SSI) is the main surgery complication which can increase morbidity, mortality, as well as the hospital cost. The prevalence of SSIs at a health care reflects its sevice quality. This study was aimed to obtain the bacterial profile of SSIs among multitraumatic patients at Prof. Dr. R. D. Kandou Hospital from June through December 2016. This was a descriptive study with a cross sectional design. Pus was obtained from SSIs of laparotomy and ORIF operation wounds, and was further examined with PCR. The results showed that of 16 samples, 3 samples were negative (18.75%) and 13 samples were positive (81.25 %). The PCR test showed that the highest percentage of bacteria was Pseudomonas aeruginosa (6 samples; 46.1%), followed by Escherichia coli (2 samples; 15.4%), and Enterobacter hormaechei, Alcaligenes faecalis, Enterobacter cloacae, Bacteroides fragilis as well as Proteus mirabilis (each of 1 sample; 7.7%). Conclusion: Based on the PCR test, there were 7 types of bacteria at the SSIs of multitraumatic patients at Prof. Dr. R. D. Kandou Hospital Manado, all of them were Gram negative, and the most common type was Pseudomonas aeruginosa.Keywords: bacterial profile, PCR, SSIs, multitraumatic patientsAbstrak: Infeksi luka operasi merupakan salah satu komplikasi utama operasi yang dapat meningkatkan morbiditas, mortalitas, dan biaya perawatan penderita di rumah sakit. Angka kejadian infeksi luka operasi pada suatu institusi penyedia pelayanan kesehatan mencerminkan kualitas pelayanan pada institusi tersebut. Penelitian ini bertujuan untuk mendapatkan pola kuman infeksi luka operasi pada pasien multitrauma di ruang perawatan bedah RSUP Prof. Dr. R. D. Kandou selama bulan Juni-Desember 2016. Jenis penelitian ialah deskriptif dengan desain potong lintang. Apusan pus diambil dari luka operasi terinfeksi pada tindakan laparotomi dan ORIF kemudian diperiksa dengan PCR. Hasil penelitian memperlihatkan dari 16 sampel yang diteliti ditemukan 3 sampel negatif (18,75%) dan 13 sampel positif (81,25 %). Berdasarkan hasil PCR ditemukan pertumbuhan kuman terbanyak ialah Pseudomonas aeruginosa sejumlah 6 sampel (46,1%), diikuti Escherichia coli sejumlah 2 sampel (15,4%), serta Enterobacter hormaechei, Alkaligenes faecalis, Enterobacter cloacae, Bacteroides fragilis, dan Proteus mirabilis, masing-masing sejumlah 1 sampel (7,7%). Simpulan: Berdasarkan hasil PCR didapatkan 7 jenis kuman pada infeksi luka operasi dari pasien multitrauma di RSUP Prof. Dr. R. D. Kandou Manado, kesemuanya tergolong bakteri Gram negatif, dan yang tersering ialah Pseudomonas aeruginosa.Kata kunci: pola kuman, PCR, infeksi luka operasi, pasien multitrauma
APLIKASI REVISED TRAUMA SCORE, INJURY SEVERITY SCORE, DAN TRAUMA AND INJURY SEVERITY SCORE DALAM MEMREDIKSI MORTALITAS PADA PASIEN MULTITRAUMA DI IRDB BLU RSUP PROF. DR. R. D. KANDOU MANADO Ranti, Jassy S. R.; Sapan, Heber B.; Kalesaran, Laurens T. B.
JURNAL BIOMEDIK : JBM Vol 8, No 2 (2016): JURNAL BIOMEDIK : JBM Suplemen
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.2.2016.12699

Abstract

Abstract: Trauma is the main cause of deaths among teenagers and young adults. Most of the cases are due to traffic accidents, therefore, a scoring system that can transforms the trauma quality to numbers is very valuable. This scoring system is needed to predict mortality, compare therapeutic methods, function as a triage tool pre hospitalization and during the way to the hospital, evaluate quality improvement and prevention program, and as a tool in trauma studies. There are several available scoring systems usually used in trauma studies, as follows: Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma Related Injury Severity Score (TRISS). This study aimed to obtain the easiest applicable scoring system to multitraumatic patients in Prof. Dr. R. D. Kandou Hospital Manado. This was an observational correlation study. Evaluation of mortality was done by using the scoring systems and then was compared to the results in the field. There were 37 multitraumatic patients consisted of 30 males and 7 females. Five patients died during this study. By using RTS, of score >7 there was 1 death; of score 6-7 there were 3 deaths; and of score-5 there was 1 death. By using ISS, all dead patients had score ?25, meanwhile by using TRISS, 2 dead patients had score 81-100,1 dead patient had score 61-80, and 2 dead patients had score 41-60. Conclusion: RTS is the easiest applicable scoring system at triage and pre-hospitalization, and is recommended to be a part of management of multitraumatic patients. Along with ISS, RTS can be used as a mortality predictor among multitraumatic patients.Keywords: trauma, RTS, ISS, TRISS, mortalityAbstrak: Trauma merupakan penyebab kematian utama pada usia remaja dan dewasa muda. Sistim penilaian (skoring) yang dapat mengubah kualitas trauma ke dalam bentuk nilai diperlukan agar dapat meramalkan mortalitas, membandingkan metode terapi, merupakan alat triase pre- dan antar rumah sakit, menilai perbaikan kualitas dan program pencegahan, serta merupakan alat dalam studi trauma. Beberapa sistem skoring yang sering digunakan dalam penelitian ialah Revised Trauma Score (RTS), Injury Severity Score (ISS), dan Trauma Related Injury Severity Score (TRISS). Penelitian ini bertujuan untuk mendapatkan pilihan sistim skoring yang paling mudah diaplikasikan pada pasien multitrauma di BLU RSUP Prof. Dr. R. D. Kandou, Manado. Jenis penelitian ialah observasional korelatif. Penilaian ini mengaplikasikan masing-masing skor terhadap angka mortalitas dan dibandingkan dengan hasil yang diperoleh di lapangan. Dalam penelitian ini terdapat 37 pasien multitrauma, terdiri dari 30 laki-laki dan 7 perempuan. Jumlah pasien yang meninggal selama penelitian ialah 5 orang. Untuk RTS, dari pasien dengan skor >7 terdapat 1 kematian; dari pasien dengan skor 6-7 terdapat 3 kematian, dan dari pasien dengan skor 5 terdapat 1 kematian. Untuk ISS, semua pasien yang meninggal memiliki skor ?25, sedangkan untuk TRISS, 2 pasien yang meninggal dengan skor 81-100, 1 pasien dengan skore 61-80, dan 2 pasien yang meninggal dengan skor 41-60. Simpulan: RTS paling mudah diaplikasikan saat triase dan fase pre rumah sakit, serta direkomendasikan untuk menjadi bagian dari pedoman penanganan kasus multitrauma. Bersama-sama dengan ISS, RTS dapat diaplikasikan sebagai prediktor mortalitas pasien multitrauma.Kata kunci: trauma, RTS, ISS, TRISS, mortalitas
Besaran Neutrofil dan Kadar C-reactive Protein sebagai Faktor Prognostik Multi Organ Failure pada Pasien Multi-trauma ., Candy; Sapan, Heber B.; Kalesaran, Laurens T. B.; Kalitouw, Ferry
Jurnal Biomedik : JBM Vol 9, No 3 (2017): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.9.3.2017.17341

Abstract

Abstract: Trauma is the leading cause of death among people under 50 years old worldwide. Severe trauma will trigger systemic inflammatory response syndrome (SIRS) which can worsen into multiple organ failure MOF). This study was aimed to evaluate whether there was a correlation between neutrophil count and C reactive protein concentration in multi-traumatic patients and whether both variables could become predictors of the occurence of MOF. This was a correlation study with a cross sectional design. There were 71 multitraumatic patients enrolled in this study, obtained from Surgery Emergency Unit of Prof. Dr. R. D. Kandou Hospital Manado; 31 of them were associated with SIRS, MODS, and MOF. The regression analysis showed that the higher the neutrophil count was, the greater the chance of the patient to suffer from MOF (P < 0.001), as well as the higher the CRP concentration, the greater the chance of the patient to suffer from MOF (P < 0.001). The cut-off point of neutrophil to MOF was 17121.7 and the specifity was higher than the sensitivity. Morover, the cut-off point of CRP to MOF was 169.7 and the specifity was higher than the sensitivity. Conclusion: There were significant correlations between the neutrophil count and MOF as well as between CRP concentration and MOF. Neutrophil count and CRP concentration could become predictors of the occurence of MOF and were significant in sensitivity and specifity in acute multi-traumatic patients.Keywords: multiple trauma, MOF, neutrophil, CRPAbstrak: Trauma merupakan penyebab kematian nomor satu pada orang berusia kurang dari 50 tahun. Trauma berat akan memicu timbulnya respons inflamasi sistemik berat (Systemic Inflammatory Response Syndrome, SIRS) yang dapat memburuk menjadi kegagalan multi-organ. Penelitian ini bertujuan untuk mengetahui ada tidaknya korelasi antara besaran neutrofil dan kadar CRP pada pasien multi-trauma, dan apakah keduanya dapat digunakan sebagai faktor prediktor dalam mendeteksi terjadinya multi-organ failure (MOF). Jenis penelitian ialah korelasi dengan desain potong lintang. Hasil penelitian mendapatkan 71 pasien multi-trauma yang dirawat di Instalasi Gawat Darurat Bedah RSUP Prof. Dr. R. D. Kandou Manado; 31 di antaranya disertai SIRS, MODS dan MOF. Hasil analisis regresi menyatakan bahwa makin tinggi besaran neutrofil maka makin besar peluang pasien untuk terjadi MOF (P < 0,001), dan makin tinggi CRP maka makin besar peluang pasien untuk terjadi MOF (P < 0,001). Cut-off point neutrofil terhadap MOF ialah 17121,7 dengan nilai spesifisitas lebih besar dari sensitivitas sedangkan cut-off point CRP terhadap MOF ialah 169,7 dengan nilai spesifisitas lebih besar dari sensitivitas. Simpulan: Terdapat hubungan bermakna antara besaran neutrofil dan MOF serta antara CRP dan MOF. Besaran neutrofil dan CRP merupakan prediktor terjadinya MOF yang mempunyai signifikansi dalam sensitivitas dan spesifisitas pada pasien dengan multi- trauma akut.Kata kunci: multi-trauma, MOF, neutrofil, CRP
Penggunaan CONUT Score sebagai Prediktor Komplikasi Pasca Pem-bedahan Kanker Kolorektal di RSUP Prof. Dr. R. D. Kandou Manado Sundah, Hendry; Mambu, Toar; Tjandra, Ferdinand; Sapan, Heber B.; Sumanti, Winfrid M.
Jurnal Biomedik : JBM Vol 11, No 1 (2019): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.11.1.2019.23212

Abstract

Abstract: Nutritional status is one of the factors that influence the metabolic and physiological conditions. Cancer patients, especially colorectal cancer (CRCA), will suffer from decreased nutritional status during their sickness. CONUT score is beneficial to evaluate the nutritional and immunity status of the patients and has been proved to correlate with post operative complications and length of stay. This study was aimed to evaluate the relationship between CONUT score and postoperative complications in CRCA patients. This was an analytical observational study with a cross sectional design. Subjects were 38 patients of CRCA that underwent operation and were admitted at Surgery Inpatients Installation of Prof. Dr. R. D. Kandou Hospital Manado. The result of logistic regression analysis indicated that there was a significant correlation between CONUT score and the risk of complication. The higher the CONUT score, the higher the risk of complication. The determination of complication diagnostic value based on CONUT score was obtained by using ROC curve. The ROC analysis showed that the AUC of CONUT score was 0.977 >0.700 and the cutoff point of CONUT score was 5.5. Patients with CONUT score >5.50 had a tendency to get postoperative complications with the sensitivity of 86.6%, specifity of 95.6%, and accuracy of 94.74%. Conclusion: CONUT score can be used as a screening method to predict the occurence of postoperative complications in CRCA patients.Kata kunci: colorectal cancer, CONUT score, postoperative complicationsAbstrak: Salah satu faktor yang memengaruhi keadaan metabolik dan fisiologik ialah status nutrisi. Penderita kanker terlebih kanker kolorektal (KKR) akan mengalami pengurangan nutrisi selama perjalanan penyakit. CONUT score bermanfaat untuk mengevaluasi status gizi dan imunitas pasien serta terbukti berkolerasi dengan komplikasi serta jumlah hari rawat di rumah sakit pasca pembedahan. Penelitian ini bertujuan untuk mengetahui hubungan CONUT score dengan komplikasi pasca pembedahan KKR. Jenis penelitian ialah analitik obser-vasional dengan desain potong lintang. Subyek penelitian ialah 38 pasien KKR yang menjalani operasi dirawat di Instalasi Rawat Inap Bedah RSUP Prof. Dr. R. D. Kandou Manado. Hasil analisis regresi logistik menyatakan terdapat hubungan yang sangat bermakna antara CONUT score dan kejadian komplikasi. Hubungan ini menyatakan bahwa makin tinggi CONUT score makin besar risiko terjadinya komplikasi. Penentuan nilai diagnostik kom-plikasi berdasarkan CONUT score diperoleh melalui kurva ROC. Berdasarkan analisis ROC diperoleh AUC CONUT score 0,977 >0,700. Hasil analisis ROC memperoleh titik potong CONUT score = 5,5. Pasien dengan CONUT score >5,50 memiliki kecenderungan mengalami komplikasi dengan sensitivitas 86,6%, spesifitas 95,6%, dan nilai akurasi 94,74%. Simpulan: CONUT score dapat digunakan sebagai metode skrining untuk memrediksi terjadinya komplikasi pasca pembedahan kanker kolorektal.Kata kunci: karsinoma kolorektal (KKR), CONUT score, komplikasi pasca pembedahan
Co-Authors ., Candy Adrian Tangkilisan, Adrian Angelica M. J. Wagiu, Angelica M. J. Anugrah H. Masloman, Anugrah H. Barung, Sidhit Harsali F. Lampus Hendri . Hendrik M. J. M. J. Tampi, Hendrik M. J. M. J. Indah J. Umboh, Indah J. Jassy S. R. Ranti, Jassy S. R. Jimmy Koan, Jimmy Jimmy Panelewen, Jimmy Julius H. Lolombulan, Julius H. Kalitouw, Ferry Kissra, Christianto Laurens T. B. Kalesaran, Laurens T. B. Leo Rendy Louise A. J. Waworuntu, Louise A. J. Mambu, Toar P. A.V. Wowiling, P. A.V. Richard M. Sumangkut, Richard M. Sumanti, Winfrid M. Sundah, Hendry Tjandra, Ferdinand Tubagus, Rudy Verro Ratuwalangon, Verro Yenzher C. Tamuntuan, Yenzher C. Yuansun Khosama, Yuansun