IMPACT Law PRACTICE OF MEDICINE ON HOSPITAL AND DOCTOR.

IMPACT Law PRACTICE OF MEDICINE

ON

HOSPITAL AND DOCTOR.

By

SETYA HERRY  Yudhautama, dr, Spb, FInaCS

Legal provisions medical practice, many arranged in a variety of product legislation; Law among others. 23 of 1992 on Health, PP. 32 Year 1996 regarding Health Workers. Besides, there's more regulation in the form of Minister of Health, who is often questioned because of the juridical aspect PERME (KES) excluding khierargi the laws of Indonesia. But "funny" its Constitution Act Praktektek medicine (BFL) No. 29 of 2004 mengamanahi that comes by candy (Article 43 BFL) so came the sweets (KES) on the Implementation 1419/menkes/per/X/2005 number (should the implementation) Practice Doctors and dentists as well as remove Permenkes 916/menkes/per/VII/1997 numbers, to "cute" it's probably one of the ambiguities in the implementation gap later. But even so because of BFL already passed and enacted by the Indonesian State Gazette No. 116 of 2004 will inevitably have been binding on the parties to any deficiency and excess. One drawback of the above rules are not yet able to answer all the challenges and issues that arise relating to implementation of the practice of medicine, is still not well integrated, as well as the uncertain shape regulation and supervision and is not optimal in the empowering potential of the profession and the institutions involved.

How will the implementation of the BFL?

LITERATURE AND REVIEW OF SOFT TISSUE TUMOR BY HERRY SETYA YUDHA UTAMA

REVIEW of THE LITERATURE

Background

The large majority of soft tissue tumours are benign, with a very high cure rate after surgical excision. Malignant mesenchymal neoplasms amount to less than 1% of the overall human burden of malignant tumours but they are life threatening and may pose a significant diagnostic and therapeutic challenge since there are more than 50 histological subtypes of STS, which are often associ- ated with unique clinical, prognostic and therapeutic features. Over the past decade, our understanding of these neo plasms has increased significantly, both from a histopathological and genetic point of view. The close interaction of surgical pathologists, surgeons and oncologists has brought about a significant increase in disease-free survival for tumours which were previously almost invariably fatal, the overall 5-year survival rate for STS in the limbs now being in the order of 65-75%. Careful physical examination and radiographic evaluation to evaluate the size, depth and location of the mass, along with signs of neurovascular involvement are essential for designing the best ther- apeutic approach

Epidemiology

Benign mesenchymal tumours outnum-ber sarcomas by a factor of at least 100. annual clinical incidence (number of new patients consulting a doctor) of benign soft tissue tumours has been estimated as up to 3000/million population whereas the annual incidence of soft tissue sarcoma is around 30/million i.e. less than 1 percent of all malignant tumours. There are no data to indicate a change in the incidence of sarcoma nor are there significant geographic differences.

kelainan pembengkakan akut pada extremitas / abnormalities acute swelling of the extremity

Pembengkakan Akut Pada Ekstremitas

 Pada tulisan kali ini saya dr, herry setya yudha utama spesialis bedah ingin memaparkan beberapa informasi penting tentang kelainan / pembengkatan akut pada ektremitas

Seringnya Edema terjadi akibat akumulasi cairan jaringan yang berlebih pada ruang interstitial. Cairan interstitial merupakan sesuatu yang bersifat statis, dimana produksi transudat merupakan hasil dari kandungan arteri dari jaringan kapiler ke ruang jaringan dan diseimbangkan melalui proses reabsorpsi oleh vena dan sistem limfatik. Sistem limfatik merupakan satu-satunya yang bertanggung jawab dalam mengeluarkan sepersepuluh dari cairan yang direabsorpsi tapi cairan ini penting bagi pengeluaran molekul-molekul protein besar dan partikel lain dari ruang intertsitial.

           beberapa  Faktor-faktor yang berperan terhadap aliran cairan intertitial meliputi: saringan pada dinding kapiler, tekanan osmotik, absorpsi sistem limfatik, tekanan jaringan, tekanan arteri dan vena. Penyebab utama dari peningkatan transudat kapiler yaitu

·         Peningkatan  tekanan kapiler yang disebabkan oleh peningkatan tekanan vena.

·         Peningkatan permeabilitas kapiler

·         Berkurangnya reabsorpsi cairan interstitial

·         Peningkatan tekanan osmotik pada cairan jaringan

·         Obstruksi atau insufisiensi sistem limfatik