Fortuna, Fory
Yayasan Lingkar Studi Bedah Plastik

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Early Detection of Elevated Serum Procalcitonin Is Required as Warning Sign of Sepsis in Burn Patients Fortuna, Fory; Wardhana, Aditya
Jurnal Plastik Rekonstruksi Vol 1 No 4 (2012): July-August Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v1i4.91

Abstract

Backgrounds: Procalcitonin (PCT) is a marker of the inflammatory response. This biomarker also plays a key role in burn injury, as it is accompanied by systemic inflammatory response syndrome (SIRS). Elevated level of serum PCT possibly interprets the state of inflammation and multiple organ dysfunctions (MOD) with the risk of lethal outcome.Patients and Methods: We detected high serum PCT level associated with its warning state of inflammation in 3 adult patients. We found that each high PCT level was continued by its state of inflammation. These four patients encounter serum PCT level into more than 10 ng/ml. Sepsis was diagnosed according to American Burn Association Sepsis Criteria.Results: High elevated PCT serum level (161.70 ng/mL) was detected on the first patient 8 days post burn injuryand died on the next 5 days. on the second patient, high PCT serum level (40.81 ng/mL) detected 9 days after burn injury and died on the next 2 days. The third patient was detected with high PCT serum level (12.28ng/mL) 2 days after burn injury was died on the next 2 days. The pediatric patient was detected with high PCT level (23.41 ng/ml)11 days after burn injury and died on the next 4 days.Summary: We found that it is important to initiate PCT measurements in burn patients at the time of admission. Daily measurement of PCT levels is needed for an early diagnosis and treatment of burn sepsis, monitoring therapy and MOD prevention.
Incomplete Cleft Palate in Cornelia de Lange Syndrome Fortuna, Fory; Kreshanti, Prasetyanugraheni; Handayani, Siti; Bangun, Kristaninta
Jurnal Plastik Rekonstruksi Vol 2 No 1 (2013): January - March Issue
Publisher : Yayasan Lingkar Studi Bedah Plastik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jpr.v2i1.126

Abstract

Background: Cornelia de Lange Syndrome (CdLS) is a rare congenital anomaly inheritance syndrome. The prevalence is 1.6-2.2/100.000 of 8,558,346 births in Europe. Cleft palate is less frequent malformation of this syndrome (21,7%) than other associated malformations. The diagnosis can be obtained clinically based on CdLS diagnostic criteria by USA CdLS Foundation. This is the first case in our hospital. Patient and Method: A case of a 4-year-old girl who came to our attention at Cleft and Craniofacial Center Cipto Mangunkusumo National General Hospital for incomplete cleft palate. Parents’ major concerns was feeding problem. The clinical investigations showed that the child met diagnostic criteria for CdLS as described in literatures. We manage this case in collaboration with paediatric department and other related specialists, including radiologist and craniofacial orthodontist. We performed Veau-Wardill-Kilner’s palataoplasty for the incomplete cleft palate. Paediatric department arranged provision of dietary. Result: This patient with incomplete cleft palate whom we treated by palatoplasty was moderately involved by CdLS (severity score 17). After 3 weeks follow-up, we have overcome feeding problem and body weight gained. Summary: Patient with CdLS needs early multidisciplinary team approach management for maximum outcome, because variety of associated malformations may present and life-threatening. Diagnostic criteria by USA CdLS Foundation assist health care personnel recognize this syndrome early.