Faktor Klinis dan Histopatologi Serta Hubungannya dengan Kekambuhan Pascaoperasi pada Pasien Kanker Payudara di RSUD Dr. Soetomo, Januari–Juni 2015

Breast cancer recurrence occurs because of factors such as surgical problem and clinicopathological features. The present study aimed to assess the relation between clinicopathological factors to breast cancer recurrence. Cross sectional design was used to take medical documents of all patients who visited Out Patient Department Soetomo Hospital from January 2015 to June 2015. A total of 228 patients were identified. The rates of breast cancer recurrence were 30%, most of recurrence occurred in first 5 years and the peak was in the first year. There were significant correlations between breast cancer recurrence and the factors observed below: tumor size [p=0.01,PR(95% CI)=1.621(1.086-2.421)]; nodal status 1-3 and ≥ 4 ≥ 4 [respectively p=0.014,PR(95%CI)=1.281(1.030-2.593) ; p=0.011,PR(95%CI) =1.289(1.038-1.601)]; tumor location [p=0.00,PR(95%CI)=2.422(1.576-3.721)]; hospital where the operation performed [p=0.03,PR(95%CI)=1.207(1.026-1.421)]; adjuvant therapy [p=0.00,PR(95%CI)= 4.371(2.231- 8.566)]. However there were no correlations of breast cancer recurrence and age, clinical stage or type of surgery. Conclusion, there are significant correlations between breast cancer recurrence and clinicopathological factors, such as tumor size, nodal status, tumor location, hospital where the operation performed and adjuvant therap

Pressure Injury Management in Critically Ill Patients with COVID-19 in a Makeshift Hospital in Indonesia: A Report of Two Cases

ABSTRACT: Patients who are critically ill with COVID-19 need ventilation support in the ICU. However, ICU patients are at higher risk of developing a pressure injury (PI). Unfortunately, PI prevention is not optimally implemented in Indonesia, especially in the makeshift hospitals created during the COVID-19 pandemic. Here, the authors report two cases of critically ill patients with COVID-19 who developed large sacral PIs during hospitalization in a makeshift hospital in Indonesia. The first patient developed a stage 3, 7 × 7-cm sacral PI on the 14th day of hospitalization. The second patient developed a stage 4, 12 × 8-cm sacral PI on the 16th day of hospitalization. Both patients had elevated d-dimer levels and used a noninvasive ventilator for 1 week. The wounds were treated with surgical debridement, silver hydrogel dressing, and hydrocolloid dressing and complemented with static air mattress overlay. The authors recommend that in situations where there is a shortage of healthcare workers, the government should provide pressure-redistribution devices and silicone foam dressings for all critically ill patients to prevent PI development and lighten the workload of healthcare workers