Background: Meningiomas are common central nervous system neoplasms, accounts for 30% of all primary intracranial neoplasms; the occurrence of meningiomas with cystic lesions is an exceptionally rare. Lymphoplasmacyte-rich meningioma (LPRM) is a rare pathological entity belong to the World Health Organization Grade I meningiomas. LPRM is characterized by abundant lymphoplasmacytic infiltrates which over-shadow the underlying meningothelial component. Case Description: A 42-year-old male was admitted to our hospital with a chronic headache for about 3 weeks prior to admission. His symptoms worsen, and subsequently, he experienced left extremities weakness about 1 week before admission. His brain magnetic resonance imaging revealed an irregular and heterogeneously enhancing solid lesion with intratumoral cystic changes at the temporal lobe. A gross total resection was performed; pathological examination revealed a cystic LPRM. Conclusion: This rare variant of meningioma is a benign tumor entity featured with massive inflammatory cell infiltration and often less proportion of meningothelial elements. Surgical resection remains the treatment of choice. This is the first report regarding cystic LPRM from Indonesia; we also summarized relevant literature upto-date, May 2020, reported LPRM cases.
Background:Malignant peripheral nerve sheath tumors (MPNSTs) constitute a group of soft tissue neoplasm with neuroectodermal origin. Most cases are small at presentation and only some have been described reaching giant dimensions.Case Description:We report two cases that were diagnosed and treated as giant MPNST of the scalp. Both patients had extensive lesion on the head with intracranial infiltration. Microsurgical resection was indicated and a vascularized free flap was used to cover the defect. During follow-up the tumors recurred and further surgical excision treatment by adjuvant radiation therapy was performed.Conclusion:MPNSTs of the scalp are rare neoplasm of the peripheral nervous system. They are aggressive lesion that can recur and their management requires a multimodality approach.
FACTORS INFLUENCING PERFORMANCE STATUS IN PATIENTS WITH INTRACRANIAL TUMOR AT CIPTO MANGUNKUSUMO GENERAL HOSPITALABSTRACTIntroduction: Patients diagnosed with malignancy have a long course of illness from diagnosis to treatment. Assessment of performance status (PS) is essential to give an overview of therapeutic readiness and patient’s prognosis. Karnofsky Performance Scale is a PS assessment used widely in neurooncology patients. This instrument can assess functional impairment among patients. To this date, clinical factors in admission time that influences KPS in hospitalized intracranial tumor has not been researched.Aim: To get an overview of KPS in hospitalized intracranial patients in Cipto Mangunkusumo General Hospital and to investigate factors that influence.Methods: The design of this research was cohort retrospective. The research was done in Cipto Mangunkusumo General Hospital using secondary data in 2015-2016. The subjects of the research were patients with intracranial tumors. Demographic, clinical status in admission, pathological anatomy, and performance status data were acquired. The data were processed and presented descriptively and analytically. Independent predictors investigated using multivariate logistic regression.Results: There were 68 subjects obtained in this research. As much as 35 (51.5%) subject had primary intracranial tumor. As much as 58 (85.2%) subjects aged <60 years old. As much as 51 (76.5%) subjects had supratentorial tumor. Majority of subjects (70%) had KPS score <70. Subjects with primary tumor had more cranial nerve palsy (p=0.021) and hemiparesis (p=0.038). Decreased consciousness increased the risk of KPS score <70 by 5.2x in the time of admission.Discussion: Majority of subjects had KPS score <70. Decreased consciousness in the time of admission is an independent predictive factor that lowers KPS.Keywords: Karnofsky Performance Scale, intracranial tumor, neurooncology, risk factorsABSTRAKPendahuluan: Pasien keganasan memiliki perjalanan penyakit yang panjang mulai dari diagnosis hingga tata laksana. Kondisi pasien dapat sangat beragam, sehingga penting dilakukan pengkajian status performa untuk memberikan gambaran kesiapan terapi dan prognosisnya. Instrumen yang paling sering digunakan secara standar internasional adalah Karnofsky Performance Scale (KPS). Sejauh ini belum diketahui penggunaan KPS pada pasien tumor intrakranial, mengingat performa pasien yang tidak hanya disebabkan oleh keganasannya, namun juga kecacatan akibat dari lesinya.Tujuan: Mendapatkan gambaran KPS pasien tumor intrakranial serta faktor-faktor yang memengaruhinya.Metode: Penelitian kohort retrospektif terhadap pasien tumor intrakranial yang dirawat di RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada tahun 2015-2016. Dilakukan pencatatan karakteristik demografik pasien, faktor klinis saat admisi, patologi anatomi, dan KPS. Data disajikan secara deskriptif dan analitik, faktor prediktor independen diinvestigasi menggunakan analisis multivariat regresi logistik.Hasil: Didapatkan 68 subjek dalam penelitian ini dengan proporsi tumor primer dan sekunder sebanyak 33 dan 35 orang. Subjek perempuan lebih banyak pada kelompok tumor primer dan lebih sedikit pada tumor sekunder. Mayoritas subjek berusia <60 tahun (85,2%), lokasi tumor di supratentorial (76,5%), dan KPS masuk <70 (69,2%). Subjek dengan penurunan kesadaran saat masuk perawatan akan cenderung memiliki KPS <70 (p=0,005) dibanding faktor-faktor klinis lainnya dengan risiko 5,2x menyebabkan status performa yang rendah tersebut saat admisi.Diskusi: Sebagian besar subjek memiliki nilai KPS <70. Penurunan kesadaran saat admisi merupakan faktor prediktif independen penurunan KPS.Kata kunci: Faktor risiko, Karnofsky Performance Scale, neuroonkologi, tumor intrakranial
Latar belakang. Stunting adalah masalah malnutrisi balita di Indonesia. Di Kalimantan Barat, prevalensinya 33,3% berdasarkan data Riskesdas 2018. Praktik pemberian MPASI yang tidak optimal berkontribusi besar pada angka itu.Tujuan. Sebagai langkah awal dalam pencegahan stunting dilakukan survei untuk mengetahui gambaran karakteristik ibu, pengetahuan, dan praktik pemberian MPASI pada bayi di kota Pontianak.Metode. Studi potong lintang dilakukan pada bulan November- Desember 2018 di tiga Puskesmas Kecamatan Kota Pontianak. Pengambilan sampel dan data primer dilakukan dengan metode consecutive sampling, wawancara dan pengisian kuisioner. Hasil. Didapatkan 110 ibu yang memenuhi kriteria inklusi dengan usia antara 26,9+5 tahun. Sebanyak 89,1% ibu memiliki gawai dan menggunakannya untuk mencari informasi nutrisi anak (82,7%). Ibu berpendapat informasi dari dokter (99,1%) yang paling terpercaya. Sebanyak 4,5% ibu memberikan MPASI dini dan 12,7% memberikan menu tunggal pada awal pemberian MPASI. Makanan pertama yang diberikan pada bayi usia 6 bulan terutama dari golongan karbohidrat dan ditemukan keterlambatan pemberian protein hewani. Sebanyak 20% ibu berpendapat bahwa garam dan gula tidak boleh diberikan pada bayi di bawah 1 tahun. Tidak semua ibu mengetahui manfaat pemberian minyak dalam MPASI dan masih terdapat 87,3% ibu yang berpendapat minyak tidak boleh diberikan pada usia di bawah 9 bulan. Dalam pemberian makan, terdapat ibu yang memberikan tontonan televisi/gawai saat makan (65,5%), memarahi (14,5%), dan memaksa anaknya untuk makan (11,8 %), Kesimpulan. Pengetahuan ibu yang kurang mengenai praktik pemberian MPASI berbasis bukti terkini masih menjadi penyebab utama praktik MPASI yang belum optimal. Intervensi edukasi yang menyeluruh melalui media gawai diperlukan untuk mengoptimalkan praktik pemberian MPASI oleh ibu.
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