Objective: The management of early breast cancer (EBC) is performed with a series of treatments consisting of surgery and systemic therapy, along with long-term endocrine therapy for hormone responsive. The treatment generates a high illness effect that will affect the life quality of EBC patients. The objective of this study was to measure EBC patients’ quality of life after undergoing the treatment.Methods: A cross-sectional study was conducted by interviewing EBC patients using EQ-5D-5L instrument at private hospitals in Yogyakarta and Semarang, Indonesia. The EBC patients were women aged 18-60 y who had undergone surgery in 2010-2013 and received endocrine therapy.Results: Of the 71 patients identified, 45 patients were in disease-free survival (DFS) state, 8 patients were in locoregional recurrence (LR), and 18 patients were in metastasis (M) state. Mobility and self-care problems occurred in patients who had metastasis (4.23%). The problem of usual activities occured in patients who had recurrence (22.54%). Most of the patients (84.51%) had pain problem, and all patients had an anxiety problem. The mean utility score (SD) in DFS patients was 0.841 (0.052), in LR patients was 0.758 (0.092), and in patients who had metastasis was 0.653 (0.104). The mean scores of EQ-5D VAS (SD) for EBC patients in DFS, LR and M health state were 86.56 (6.29), 81.88 (5.30), and 69.17 (5.75), respectively.Conclusion: The health states of EBC significantly affect HRQOL of patients. Efforts should be made to improve the quality of life of EBC patients especially in terms of pain and anxiety reduction.
The medical problems encountered in geriatric patients cause the prescribing to be susceptible to polypharmacy so that the possibility of creating Drug Related Problems (DRPs) is likely. Beers Criteria is one method to avoid the occurrence of DRPs. This study aims to evaluate prescribing of geriatric patients based on the Beers Criteria 2015 at the internal medicine clinic in the outpatient installation of K.R.M.T Wongsonegoro Hospital Semarang. This research was an descriptive observational study using retrospective data from geriatric patients' medical records at the internal medicine clinic in the outpatient installation of K.R.M.T Wongsonegoro Hospital Semarang in the period October - December 2017. A total of 300 medical records were taken at simple random as samples. Data for each patient were only taken once during the study period. The patient is a national health insurance participant and is ≥60 years old. The data obtained was then identified using Beers Criteria 2015. Based on the prescription of 300 geriatric patients in the internal medicine clinic in Wongsonegoro Hospital Semarang, it is known that 88,33% patients received prescription included in Beers Criteria 2015. The five medicine most prescribed are Na diclofenac, omeprazole, digoxin, ranitidine, and diazepam. Medications included in Beers Criteria are medicine that should not be given to geriatric patients so that caution is needed in the use of these medicine.
ABSTRAKTerapi adjuvan pada pasien early breast cancer (EBC) bertujuan untuk meningkatkan disease free survival, menurunkan risiko relaps dan menurunkan angka kematian. Tetapi pada kenyataannya masih sering dijumpai, pasien EBC yang telah mendapat terapi adjuvan mengalami relaps. Kejadian relaps sering dihubungkan dengan meningkatnya risiko kematian tanpa memperhatikan jenis pengobatan. Tujuan penelitian ini adalah mengetahui angka kejadian relaps pada pasien premenopausal EBC yang telah mendapatkan terapi adjuvan di RSUP dr. Sardjito Yogyakarta. Penelitian ini merupakan penelitian deskriptif observasional dengan desain cross sectional study menggunakan data retrospektif yang diperoleh dari data rekam medik pasien premenopausal EBC di Poliklinik Kanker Terpadu "Tulip" RSUP dr. Sardjito Yogyakarta yang telah mengalami tindakan pembedahan pada tahun 2010-2013, bersifat hormon responsif dan HER-2 negatif, mendapatkan terapi adjuvan, perempuan dengan umur 18-60 tahun dan riwayat pemeriksaan sampai bulan Desember 2016. Pasien akan di eksklusi bila mempunyai penyakit penyerta. Dari 30 pasien diketahui sebanyak 46,67% berumur 41-50 tahun, sebanyak 63,33% menunjukkan ekspresi ER-PR positif, sebanyak 93,34% merupakan invasive ductal carcinoma (IDC). Semua pasien mendapatkan terapi adjuvan kemoterapi menggunakan regimen kombinasi dan semua pasien mendapatkan terapi endokrin berupa tamoksifen. Relaps terjadi pada 11 pasien (36,67%) dan kejadian relaps paling banyak adalah metastasis tulang yaitu pada 8 pasien (26,67%). Kata kunci : premenopausal, EBC, adjuvan, relaps ABSTRACTAdjuvant therapy in patients with early breast cancer (EBC) aims to improve disease free survival, decrease the risk of relapse and reduce mortality. But in reality they often encountered, EBC patients who had received adjuvant therapy relapse. The incidence of relapse is often associated with increased risk of death regardless of the type of treatment. The purpose of this study was to determine the incidence of relapse in patients premenopausal EBC who have received adjuvant therapy in RSUP dr. Sardjito Yogyakarta. This study is a descriptive observational with cross sectional design using retrospective data obtained from medical records premenopausal EBC patients at Integrated Cancer Clinic "Tulip" RSUP dr. Sardjito Yogyakarta who have undergone surgery in 2010-2013, are hormone responsive and HER-2 negative, have received adjuvant therapy, women aged 18-60 years and a history of the last inspection in December 2016. Patients were excluded if would have comorbidities. From 30 patients known to as much as 46.67% aged 41-50 years, as many as 63.33% showed positive expression of ER-PR, as much as 93.34% is the IDC. All patients received adjuvant therapy of chemotherapy using a combination regimen and all patients received endocrine therapy such as tamoxifen. Relapses occurred in 11 patients (36.67%) and the most incidence of relapse is bone metastasis in 8 patients (26.67%).
Perubahan paradigma pelayanan kesehatan dari “quality” menjadi “quality and safety” bertujuan untuk meningkatkan kualitas hidup pasien. Salah satu upaya adalah meminimalkan terjadinya insiden. Insiden keselamatan pasien yang menempati angka terbesar adalah Kejadian Nyaris Cidera (KNC), yaitu sebesar 18,53%. Peningkatan risiko terjadinya KNC dapat disebebkan oleh adanya polifarmasi. Polifarmasi sering dialami pada pasien di Poli Penyakit Dalam RS Roemani Muhammadiyah Semarang. Penelitian ini bertujuan untuk mengetahui jumlah KNC pada pelayanan resep pasien poli penyakit dalam di Instalasi Farmasi Rawat Jalan RS Roemani Muhammadiyah Semarang. Penelitian merupakan penelitian deskriptif observasional dengan data prospektif dari pelayanan resep pasien poli penyakit dalam di Instalasi Farmasi Rawat Jalan RS Roemani Muhammadiyah Semarang pada bulan Maret 2020. Evaluasi dilakukan pada setiap tahapan pelayanan resep. Tahapan terdiri dari peng-entry-an resep, pengambilan obat, dan penyiapan obat. Data dianalisis dan dikelompokkan berdasarkan jenis KNC pada tiap tahapan pelayanan resep pasien penyakit dalam, jumlah dan persentase KNC pada setiap lembar resep. Hasil penelitian menunjukkan bahwa terdapat 25 KNC pada 375 lembar resep pasien poli penyakit dalam di Instalasi Farmasi RS Roemani Muhammadiyah Semarang. Persentase KNC adalah tahap peng-entry-an obat sebanyak 9 KNC (2,4%), tahap pengambilan sebanyak 15 KNC (4%), tahap penyiapan sebanyak 1 KNC (0,27%)
Dengue hemorrhagic fever (DHF) threatens people in the rainy season. DHF is one of the major public health problems in Indonesia. These problems encourage an effort to eradicate Ae. aegypti larvae by using natural larvicide. One of the plants that can be used as natural larvicides is avocado seeds (Persea americana Seed) which contain saponin. This study aims to determine the larvacidal activity of avocado seed extract sandgranules with LC50 of 8.87 mg.mL-1 against Ae. aegypti larvae. This study is an experimental research with a complete random design in a unidirectional pattern. The independent variable in this study is the variation concentration of Explotab as a disintegrant agent ie 2, 3, and 4%. Sand granules of avocado seed extract are made by wet granulation method. Results of the larvacidal activity test of avocado seed extract sand granules were analyzed by calculating the percentage of larvae mortality and statistical analysis using SPSS. The results of this study is the larvacidal activity of pure avocado seed extract with LC50 8.87 mg. L-1 is greater than the avocado seed extract sand granules. The addition of Explotab did not affect the total larvae mortality, but there was a significant difference in larvae mortality at 5 hours of sand granules exposure with explotab concentration of 3% and 4% (a significance value <0.05).
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