Large pneumothorax with long duration of symptoms can be dangerous. Large pneumothorax can cause hypoxemia and its duration states the duration of hypoxia. This long duration of hypoxia can affect changes in tissue conditions of the lungs, which if it reaches 72 hours can increase the permeability of the alveolar capillaries in the lungs to facilitate pulmonary edema. Large pneumothorax with long duration of symptoms can be a risk factor for re-expansion pulmonary edema (REPE). Meanwhile, hypoxia can also cause increased production of free radicals in lung tissue (pulmonary oxidative stress). This study investigated whether the duration of pneumothorax also affects the level of pulmonary oxidative stress, with experiments in rats. There were 4 groups consisting of 6 rats in each group: 24 hours of pneumothorax (A), 48 hours of pneumothorax (B), 72 hours of pneumothorax (C) and control (D). Pneumothorax is made by injecting air into the right pleural cavity of the chest, then we performed X-ray. All samples were examined for PaO 2 to ensure hypoxia status. After that, the rats were examined for malondialdehyde (MDA) levels to express the level of oxidative stress. The result showed that all pneumothorax groups were hypoxemic (PaO 2 below 80 mmHg). Mean MDA levels were higher in pneumothorax groups. However, only group C were significantly higher (p=0,031). MDA levels were 1,601 ± 0,739 in group A, 1,585 ± 0,714 in group B, 2,256 ± 0,513 in group C, and 1,243 ± 0,162 in group D. We concluded that pneumothorax can cause pulmonary oxidative stress if the pneumothorax has a large volume and the duration of symptoms reaches 72 hours.
Latar belakang. Tidak semua kelainan jantung menimbulkan gejala klinis. Pemeriksaan ekokardiografi tidak semuanya tersedia di fasilitas kesehatan terbatas.Tujuan. Untuk mendeteksi kelainan jantung pada siswa-siswi sekolah dasar di Palembang melalui pemeriksaan auskultasi jantung dan elektrokardiografiMetode. Desain penelitian uji diagnostik dengan pendekatan cross sectional pada siswa-siswa sekolah dasar di kota Palembang. Penelitian dilakukan dari bulan Agustus sampai dengan November 2019. Subyek penelitian sebanyak 280 anak sekolah dasar. Semuanya dilakukan pemeriksaan auskultasi jantung, elektrokardiografi, dan ekokardiografiHasil. Subyek 280 anak sekolah dasar, terdiri dari 130 laki-laki dan 150 perempuan. Rerata umur 9,6 tahun (rentang 5-14) tahun. Median berat badan 27 kg. Pada pemeriksaan auskultasi ditemukan 79,2% normal, 9,2 % bising sistolik, 2,1 % bising diatolik, dan 7,1 % bising inosen. Hasil elektrokardiografi, normal 97,1%, sinus takikardi 1,4%, sinus bradikardi 0,4%, hipertrofi ventrikel kiri 0,7 %, right bundle branch block 0,4%. Hasil ekokardiografi, penyakit jantung rematik subklinis 20 anak, persisten foramen ovale 1 anak, pulmonal stenosis 2 anak dan hipertensi pulmonal primer 10 anak. Sensitivitas dan spesifisitas auskultasi jantung 90% dan 91%. Nilai prediksi positif dan negatif auskultasi jantung 57,69% dan 98,6%. Sensitivitas dan spesifisitas elektrokardiografi 6,06% dan 97,57%. Nilai prediksi positif dan negatif elektrokardiografi 25% dan 88,6%.Kesimpulan. Auskultasi jantung cukup akurat untuk deteksi awal kelainan jantung pada anak dibandingkan elektrokardiografi.
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