Pengaruh Radioterapi Terhadap Kadar TSH dan T4 pada Pasien Tumor Ganas Kepala dan Leher

Latar belakang: Tumor ganas kepala dan leher adalah tumor ganas yang berasal dari epitel traktus aerodigestif atas. Radioterapi adalah salah satu modalitas talaksana pada tumor ganas kepala dan leher. Kelenjar tiroid akan terpapar radioterapi selanjutnya merangsang terjadinya kelainan pada kelenjar tiroid. Hipotiroid merupakan efek samping yang paling umum terjadi akibat radioterapi. Diagnosis hipotiroid ditegakkan melalui pemeriksaan laboratorium yaitu didapatkan peningkatan TSH dan penurunan T4. Tujuan: Mengetahui pengaruh radioterapi terhadap kadar TSH dan T4 pasien tumor ganas kepala dan leher di RSUP Dr. M. Djamil, Padang. Metode: Analitik cross sectional dengan desian pre and post test only pada 10 responden tumor ganas kepala dan leher. Sampel berupa darah vena yang dihitung kadar TSH dan T4 menggunakan alat Vidas 3. Data dianalisis dengan uji t berpasangan. Hasil analisis statistik dinyatakan bermakna bila didapatkan hasil p<0,05. Hasil: Nilai rerata kadar TSH sebelum dan setelah radioterapi didapatkan 0,57 ± 0,512 µIU/ml. Nilai rerata kadar T4 sebelum dan setelah radioterapi didapatkan 0,721 ± 0,508 µg/dL. Uji t bepasangan didapatkan peningkatan rerata kadar TSH setelah radioterapi dengan p = 0,004 yang menunjukkan peningkatan bermakna rerata kadar TSH setelah radioterapi dan didapatkan penurunan rerata kadar T4 setelah radioterapi dengan p = 0,001 yang menunjukkan penurunan bermakna rerata kadar T4 setelah radioterapi. Kesimpulan: Terdapat peningkatan bermakna rerata kadar TSH serta penurunan rerata kadar T4 sebelum dan setelah radioterapi pada pasien tumor ganas kepala dan leher walau belum melewati nilai normal.ABSTARCTBackground: Head and neck cancers are malignancies that originate from upper aerodigestive tract epithelium. Radiotherapy is one of the modalities treatments for head and neck cancer. Thyroid glands which exposed by radiotherapy, furthermore can induce abnormalities. Hypothyroid is a most common abnormality that occur after radiotherapy. Diagnosis hypothyroidism can be established through laboratory examination that is obtained an increased levels of TSH and decreased levels of T4. Purpose: To determine effect radiotherapy on levels of TSH and T4 in patients with head and neck cancer in Dr. M. Djamil Hospital, Padang. Methods: Cross sectional analytic study with pre and post test only on 10 respondents with head and neck cancer. Samples taken from venous blood then TSH and T4 were counted with Vidas 3. Data was analyzed with paired t-test. The statistical result was significant with p<0,05. Result: Mean value of TSH before and after radiotherapy is 0,57 ± 0,512 µUI/ml. Mean value of T4 before and after radiotherapy is 0,721 ± 0,508 µg/dL. From paired t-test resulted an increase of TSH mean value after radiotheraphy with p = 0,004 which implies a significant enhancement of TSH mean value after radiotheraphy and decreasing T4 mean value after radiotheraphy with p = 0,001 which implies a significant deflation of T4 mean value after radiotheraphy. Conclusions: There was significant enhancement of TSH mean and significant deflation of T4 mean value before and after radiotherapy on patients with head and neck cancer even still within normal value. Keywords: Radiotheraphy, TSH, T4, head and neck cancer.

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Pengaruh Pelatihan Kader Posbindu Terhadap Perilaku Deteksi Dini Hipertensi Pada Usia Dewasa

Jurnal Kesehatan Panrita Husada ◽

10.37362/jkph.v5i1.315 ◽

2020 ◽

Vol 5 (1) ◽

pp. 43-52

Author(s):

Asri ◽

Sigit Mulyono ◽

Uswatul Khasanah

Keyword(s):

Early Detection ◽

Total Sample ◽

Mean Value ◽

T Test ◽

Test Analysis ◽

Before And After ◽

Post Test ◽

Change In The Mean ◽

The Mean ◽

Paired T Test

The problem of hypertension in adulthood is very important to be a concern because it can cause both acute and chronic diseases such as heart and blood vessel disease, Posbindu cadre training is an activity carried out as an effort to improve skills and knowledge of early detection of hypertension so that the presence of cadres who are the spearhead in health services in the community are able to detect hypertension early. The purpose of this study was to determine the effect of posbindu cadre training on early detection of hypertension in adulthood. This research design uses the Quasi One Group Experiment pre-test Post Test with Paired T-Test. The population in this study was all people suffering from hypertension with a total sample of 84 people. The results showed that there was a change in the mean value before and after the training that was equal to 82 then to 87. The results of the Paired T-test analysis showed that there was an influence of the posbindu cadre training on the behavior of early detection of hypertension where the value (P = 0.001).

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Assessment of Quality of Life among Head and Neck Cancer Patients

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v6i1.625 ◽

2020 ◽

Vol 6 (1) ◽

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Treatment Method ◽

Cross Sectional Study ◽

Cross Sectional ◽

Before And After ◽

Oncology Center

Objective: Head and neck cancer is a common malignancy with increasing incidence worldwide. This study evaluates the quality of life of the patients undergoing treatment at the oncology center in Yazd, Iran. Methods: This cross-sectional study was conducted on 29 patients with oral and head and neck cancer that were referred to the oncology center of Shahid Sadoughi hospital in Yazd between May 2015 and February 2016. Data were collected using the UW-QOL questionnaire and a demographic questionnaire. The illness-related information was obtained from the patients’ medical records. Questionnaires were administered before the treatment and 6 months after its completion. Data analysis was performed in SPSS 21 using chi-square and ANOVA tests. P-values of less than 0.05 were considered statistically significant. Results: The sample consisted of 17 (58.6%) women and 12 (41.4%) men with a mean age of 40.00±14.30 years. The most frequent cancer location was the oral cavity and the most frequent treatment method was surgery. The mean score of quality of life before and after treatment was 12.60±2.81 and 11.39±2.63 respectively. The most important issues of the patients before and after treatment were pain and saliva respectively. Stage 3 and 4 patients had a significantly lower quality of life than stage 1 and 2 patients. Conclusion: The study found that undergoing treatment affects some dimensions of quality of life. Hence, choosing the best treatment method with due attention to side effects and follow-up sessions is recommended.

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Perbedaan Pengetahuan Siswa Tentang Penyakit Hepatitis A Sebelum Dan Sesudah Penyuluhan Di MTsN 02 Bondowoso Tahun 2015

Jurnal Ilmu Kesehatan ◽

10.32831/jik.v4i2.85 ◽

2017 ◽

Vol 4 (2) ◽

pp. 14

Author(s):

Putri Megasari

Keyword(s):

Hepatitis A ◽

Hepatitis Virus ◽

Sampling Technique ◽

Mean Value ◽

Test Design ◽

The World ◽

Before And After ◽

Post Test ◽

The Mean ◽

Paired T Test

Hepatitis has become a health problem in the world. The hepatitis virus infected many people. According to the teacher of MTsN 02 Bondowoso more than 20 students have hepatitis A viral infection. The purpose of this research was to know the differences of students' knowledge about hepatitis A before and after counseling in MTsN 02 Bondowoso 2015. This study used pre-experimental (pre-post test design). This study used stratified random sampling technique, 127 students from 270 sample involved this research,and 143 students was excluded. We used questionnaires to collect data. The results showed that the mean value of the students 'knowledge about hepatitis A before counseling in MTsN 02 Bondowoso 2015 was 83.96 with the lowest value of 37.5 and the highest value was 100. The mean value of the students' knowledge about hepatitis A after counseling in MTsN 02 Bondowoso 2015 was 93.21 with the lowest value waf 62.5 and the highest value was 100. Paired t test showed that t (-9.07) > t table (1.98), the null hypothesis (H0) was rejected. There was a difference between students' knowledge about hepatitis A before and after counseling in MTsN 02 Bondowoso 2015. This study showed that routine counseling by healthcare provider was important to prevent hepatitis A infection.; Keywords: counseling, knowledge of students, hepatitis

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NUTRITION ASSESSMENT IN HEAD AND NECK CANCER PATIENTS PRE and POST CHEMORADIOTHERAPY.

SRMS Journal of Medical Science ◽

10.21761/jms.v2i02.5 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Piyush Kumar ◽

Bhavya P Pateneedi ◽

Dharam P Singh ◽

Arvind K Chauhan

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Nutritional Risk ◽

Total Leukocyte Count ◽

Risk Indicator ◽

Anthropometric Parameters ◽

Skin Fold Thickness ◽

Before And After

INTRODUCTION: Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. Deterioration of the nutritional status results in an increase in chemo radiotherapy related toxicity and this may increase the prolonged treatment time, which has been associated with poor clinical outcome. The present study aims to do nutritional assessment before and after chemo radiotherapy in head and neck cancer patients. MATERIAL AND METHODS: The present study was undertaken at the Department of Radiation Oncology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly. In this study, 50 patients of Head and neck tumours were enrolled and their nutrition was assessed before and after chemoradiotherapy. Nutrition assessment was done using different laboratory parameters like haemoglobin, total leukocyte count, blood urea, serum creatinine and serum bilirubin. Anthropometric parameters used are Body mass index, Skin fold thickness, and Mid-arm circumference. Nutritional risk indicator and PG-SGA score is measured before and after chemoradiotherapy. All the parameters were assessed and analysed using different statistical tests- Chi-square test, Fisher Exact test and paired t test.RESULTS: Haemoglobin decrease was statistically significant during treatment (p less than 0.001) and the decrease in total leukocyte count during treatment was showing trend towards significance (p value-0.056). There was deterioration in other parameters like blood urea, serum creatinine and serum bilirubin but was not statistically significant. Anthropometric parameters- Body mass index, mid-arm circumference and skin fold thickness and percent body fat showed a significant change (p less than 0.00001). Nutritional risk indicator and PG-SGA class has decreased for majority of patients during treatment, the change is statistically significant (p less than 0.00001 and p=0.0251) respectively.CONCLUSION: The nutrition has important role to play in the management of head and neck cancers by chemo radiotherapy. It helps to reduce the complications and improve the tolerance of chemo radiotherapy, thus avoiding treatment breaks which may lead to failure of treatment.

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High rates of postoperative radiotherapy delay in head and neck cancer before and after Medicaid expansion

Head & Neck ◽

10.1002/hed.26736 ◽

2021 ◽

Author(s):

John Pang ◽

Farhoud Faraji ◽

Erik Risa ◽

Loren K. Mell ◽

Jeffrey J. Houlton ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Postoperative Radiotherapy ◽

Medicaid Expansion ◽

Before And After

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Changes in carnitine levels through induction chemotherapy in head and neck cancer patients as a potential cause of therapy-related malaise

BMC Cancer ◽

10.1186/s12885-021-08471-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tatsuya Ito ◽

Kiyoaki Tsukahara ◽

Hiroki Sato ◽

Akira Shimizu ◽

Isaku Okamoto

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Induction Chemotherapy ◽

Neck Cancer ◽

Cancer Site ◽

Primary Cancer ◽

Analog Scale ◽

Before And After ◽

Primary Cancer Site ◽

Total Carnitine

Abstract Background Carnitine is related to malaise, and cisplatin is associated with decreased carnitine. The purpose of this study was to elucidate the effects of one course of induction chemotherapy (IC) for head and neck cancer on blood carnitine levels, focusing on free carnitine (FC). Methods This single-center prospective study investigated 20 patients diagnosed with primary head and neck cancer who underwent IC with cisplatin, docetaxel, and 5-fluorouracil. FC, acylcarnitine (AC), and total carnitine (TC) levels were measured before starting therapy and on Days 7 and 21 after starting IC. In addition, malaise was evaluated before and after therapy using a visual analog scale (VAS). Results All subjects were men and the most common primary cancer site was the hypopharynx (9 patients). FC levels before starting therapy and on Days 7 and 21 were 47.7 ± 2.2 μM/mL, 56.7 ± 2.2 μM/mL, and 41.1 ± 1.9 μM/mL, respectively. Compared with the baseline before starting therapy, FC had significantly decreased on Day 21 (p = 0.007). AC levels before starting therapy and on Days 7 and 21 were 12.5 ± 1.2 μM/mL, 13.6 ± 1.4 μM/mL, and 10.7 ± 0.7 μM/mL, respectively. TC levels before starting therapy and on Days 7 and 21 were 60.2 ± 2.5 μM/mL, 70.2 ± 3.3 μM/mL, and 51.7 ± 2.3 μM/mL, respectively. No significant differences in AC, TC or VAS were seen before the start of therapy and on Day 21. Conclusions After IC, a latent decrease in FC occurred without any absolute deficiency or subjective malaise.

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Clinical utility of a functional lumen imaging probe in management of dysphagia following head and neck cancer therapies

Endoscopy ◽

10.1055/s-0043-110670 ◽

2017 ◽

Vol 49 (09) ◽

pp. 848-854 ◽

Cited By ~ 9

Author(s):

Peter Wu ◽

Michal Szczesniak ◽

Julia Maclean ◽

Lennart Choo ◽

Harry Quon ◽

...

Keyword(s):

Head And Neck Cancer ◽

Diagnostic Accuracy ◽

Head And Neck ◽

Neck Cancer ◽

Characteristic Curve ◽

Diagnostic Tools ◽

Cross Sectional ◽

Imaging Probe ◽

Functional Lumen Imaging Probe ◽

Dysphagic Patients

Abstract Background and aims Chemoradiotherapy for head and neck cancer (HNC) with/without laryngectomy commonly causes dysphagia. Pharyngoesophageal junction (PEJ) stricturing is an important contributor. We aimed to validate a functional lumen imaging probe (the EndoFLIP system) as a tool for quantitating pretreatment PEJ distensibility and treatment-related changes in HNC survivors with dysphagia and to evaluate the diagnostic accuracy of EndoFLIP-derived distensibility in detecting PEJ strictures. Methods We studied 34 consecutive HNC survivors with long-term (> 12 months) dysphagia who underwent endoscopic dilation for suspected strictures. Twenty non-dysphagic patients undergoing routine endoscopy served as controls. PEJ distensibility was measured at endoscopy with the EndoFLIP system pre- and post-dilation. PEJ stricture was defined as the presence of a mucosal tear post-dilation. Results PEJ stricture was confirmed in 22/34 HNC patients (65 %). During distension up to 60 mmHg, the mean EndoFLIP-derived narrowest cross-sectional area (nCSA) in HNC patients with strictures, without strictures, and in controls were 58 mm2 (95 % confidence interval [CI] 22 to 118), 195 mm2 (95 %CI 129 to 334), and 227 mm2 (95 %CI 168 to 316), respectively. A cutoff of 114 mm2 for the nCSA at the PEJ had perfect diagnostic accuracy in detecting strictures (area under the receiver operating characteristic curve = 1). In patients with strictures, a single session of dilation increased the nCSA by 29 mm2 (95 %CI 20 to 37; P < 0.001). In patients with no strictures, dilation caused no change in the nCSA (mean difference 13 mm2 [95 %CI −4 to 30]; P = 0.13). Conclusions EndoFLIP is a highly accurate technique for the detection of PEJ strictures. EndoFLIP may complement conventional diagnostic tools in the detection of pharyngeal outflow obstruction.

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Distinct Imaging Modalities in Head and Neck Cancer: Benefits and Drawbacks

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4554 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2777-2784

Author(s):

Dana Merin ◽

Roshni P R

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Imaging Techniques ◽

Precise Determination ◽

Imaging Biomarkers ◽

Selection Strategies ◽

Positron Emission ◽

Before And After ◽

Oncological Imaging

This review mainly focuses on the distinct imaging techniques in for head and neck cancer (HNC), its altered techniques used in diagnosis and its applications. It also depicts the upcoming imaging methods present in the field of HNC causing areas. It explains precise determination regarding the degree and extends of neoplasm. We mainly look on to the MRI(Magnetic resonance imaging), PET(Positron emission tomography), CT (computed tomography)imaging biomarkers for the management of HNC. It plays an important role in the therapy selection strategies and also enhances the therapeutic ratio in the management of HNC. The role of imaging techniques become increasingly more crucial in the management process in locally progressed head and neck squamous cell carcinoma(HNSCC). In this structure, PET allows non-invasive assessment of a range of tumour biomarkers such as metabolism, hypoxia and proliferation. MRI techniques such as can characterize different tissues by probing into their microstructure, providing a novel methodology in oncological imaging. CT, MRI, and PET/CT are widely used to determine the presence and extent of the tumours before and after treatment. This review depicts a synopsis of the most recent imaging strategies and imaging recommendations for every one of the different strides along the clinical way of patients with head and neck malignant growth.

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Serum enzymes in head and neck cancer. II Aliesterase

The Journal of Laryngology & Otology ◽

10.1017/s0022215100102798 ◽

1987 ◽

Vol 101 (8) ◽

pp. 819-822 ◽

Cited By ~ 5

Author(s):

Harbans Lal ◽

H. C. Madan ◽

G. S. Kohli ◽

S. P. S. Yadav

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Mean Value ◽

Serum Enzymes ◽

The Mean

AbstractSerum aliesterase levels have been estimated in 38 patients with head and neck cancer. The mean value was significantly lower than in controls. The decrease in activity was greater in patients with ulcerative growths and it progressed with advancement in the stage of cancer.With radiotherapy, a progressive and significant increase in serum aliesterase activity was observed. In patients with non-malignant growths the activity was comparable with that in controls.

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