Lung cancer is known as the most common malignancy in the world in terms of incidence and death rate. GLOBOCAN data in 2018 showed that its prevalence reaches 11.6% with mortality reaching 1.7 million annually. The prevalence of lung cancer in Indonesia is also considerably high; there were 25,332 cases in men and 9,374 cases in women with mortality reaching 308,660 people. In general lung cancer is classified as non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Although it is less common, SCLC has a worse prognosis with a 5 year survival rate of 6.4%. In addition, SCLC is also often diagnosed when it has metastasized or already reaced extensive stage (ES-SCLC). Although SCLC is classified as chemo-responsive cancer, the overall outcome of first-line and second-line therapy is still unsatisfactory with an ORR of 10-25%. One of characteristic of SCLC is genomic instability which relates to high level of mutations especially EGFR mutation that strongly correlate with therapeutic outcome. Therefore, targeting EGFR mutation is a sensible and potential field in developing SCLC therapy. EGFR-CpG-ODN nanovaccine is one of the potential therapeutic choices that exploit this mutation. EGFR CpG ODN nanovaccine could inhibit resistance to EGFR TKI, increased dendritic cell maturation, inhibit cancer cell proliferation and apoptosis, as well as enhance the anticancer immune response. Therefore, this therapeutic approach is a promising future therapy for SCLC petients that could improve patient’s survivability.
‘Pelangi’ (Persatuan Layang-Layang Bali) or Bali Kite Association, held a kite flying festival from early July until the end of October 2017. It aims to preserve culture, stimulate creativity and grow bond and togetherness among societies as well as become a tourist attraction. Government supports the festival as means of cultural preservation as well as a tourist attraction for domestic and foreign. However, as time goes by, the land to play kite is getting narrower due to development. Therefore, attention and participation by local government and society are needed to maintain the availability of land for the sake of the preservation of this cultural festival.
Introduction: Thoracic trauma is one type of trauma with a high incidence that causes morbidity and mortality after head trauma and extremity. The act of installing a thoracostomy has become one of the standard management of thoracic injury. Infection is a complication that can occur during treatment. This study aimed to provide an overview of the results of thoracostomy tube watersealed drainage (WSD) culture in pneumothorax patients at Sanglah Hospital. Method: The study design used a cross sectional descriptive method. The subjects of the study were blunt thoracic trauma patients with pneumothorax who came to the emergency department of Sanglah Hospital to indicate the installation of a thoracostomy hose during the period January to December 2018. Results: From 40 study samples there were 32 subjects with positive culture results, then from all subjects with positive culture results found 10 people (25%) with culture results of staphylococcal aureus bacteria, based on rib fractures more samples with rib fractures less than two bones (62.5%), based on the duration of WSD installation there were more samples with the duration of WSD installation more than 7 days (75%). Conclusion: The high positive culture results which are dominated by pyogenic skin bacteria, namely Stapylokokus aureus is a challenge for surgeons in managing the complications of tube thoracostomy (TT) installation in patients with pneumothorax.
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