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"Edition after edition, Williams Hematology has guided generations of clinicians, biomedical researchers, and trainees in many disciplines through the origins, pathophysiological mechanisms, and management of benign and malignant disorders of blood cells and coagulation proteins. It is acknowledged worldwide as the leading hematology resource, with editors who are internationally regarded for their research and clinical achievements and authors who are luminaries in their fields. The Ninth Edition of Williams Hematology is extensively revised to reflect the latest advancements in basic science, translational pathophysiology, and clinical practice. In addition to completely new chapters, it features a full-color presentation that includes 700 photographs, 300 of which are new to this edition, and 475 illustrations. Recognizing that blood and marrow cell morphology is at the heart of diagnostic hematology, informative color images of the relevant disease topics are conveniently integrated into each chapter, allowing easy access to illustrations of cell morphology important to diagnosis. Comprehensive in its depth and breath, this go-to textbook begins with the evaluation of the patient and progresses to the molecular and cellular underpinnings of normal and pathological hematology. Subsequent sections present disorders of the erythrocyte, granulocytes and monocytes, lymphocytes and plasma cells, malignant myeloid and lymphoid diseases, hemostasis and thrombosis, and transfusion medicine. "

"To provide the most current concepts of the genetic basis, pathophysiology, diagnosis and treatment of hematological diseases"

"Pendahuluan: Trombosis Vena Dalam pada pasien tumor ganas tungkai bawah sering kali terjadi tanpa terdeteksi. Banyak faktor seperti usia, jenis kelamin, indeks massa tubuh, jenis tumor, metastasis, fraktur patologis, differential count, kadar fibrinogen, kadar D-dimer, rasio PT, rasio APTT, Neutrophil-Lymphocyte Rasio (NLR), Platelet-Lymphocyte Rasio (PLR) dan Khorana risk score yang dapat mempengaruhi kejadian TVD.

 

Metode: Penelitian ini menggunakan desain potong lintang di RSUPN Cipto Mangunkusumo dengan total sampling. Pasien dengan tumor ganas tungkai bawah selama periode September 2020 hingga September 2021 dilihat usia, jenis kelamin, indeks massa tubuh, jenis tumor, metastasis, fraktur patologis, differential count, kadar fibrinogen, kadar D-dimer, rasio PT, rasio APTT, NLR, PLR dan Khorana risk score.

 

Hasil: Dari 45 subjek penelitian dengan tumor ganas tungkai bawah, 4 positif TVD. Dari pengujian bivariat dengan uji statistik yang sesuai, tidak didapatkan hubungan yang bermakna antara data dasar pasien seperti jenis kelamin (p= 0.608), IMT (p=0.651), tipe tumor (p=0.754), fraktur patologis (p=0.754), metastasis (p=0.679), operasi (p=1.000), lokasi tumor (0.840), venektasi (p=0.561), dan kemoterapi (p=0.617). Pada penelitian ini ditemukan hubungan signifikan antara rasio prothrombin time (PT) dengan kejadian TVD (P = 0.012). Variabel yang berkorelasi signifikan secara statistic antara lain tipe tumor (p=0.023) dan kondisi fraktur patologis (p=0.026). Terdapat hubungan yang bermakna antara variable venektasi dengan kadar D-dimer (p=0.002). Didapatkan korelasi signifikan antara kadar D-dimer dengan skor faktor risiko Khorana (p= 0.039). Didapatkan hubungan yang bermakna secara signifikan antara variabel fraktur patologis dengan kadar Rasio Platelet-Limfosit (p=0.023). Terdapat 4 variabel yang secara statistic berhubungan signifikan dengan Khorana risk score yaitu Hb (p=0.011), leukosit (p=0.005), hematokrit (p=0.047) dan D-dimer (p=0.035).

 

Kesimpulan: Angka kejadian TVD pada tumor ganas tungkai bawah cukup rendah yaitu 8.89%, di mana tidak terdapat hubungan yang bermakna secara statistic antara variabel karakterisitik maupun laboratorium darah dengan kejadian TVD

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Introduction: Deep Vein Trombosis in patients with malignant tumors of the lower limbs often goes undetected. Many factors such as age, sex, body mass index, tumor type, metastasis, pathological fracture, differential count, fibrinogen level, D-dimer level, PT rasio, APTT rasio, NLR, PLR and Khorana risk score may affect the incidence of DVT

Methods: This study used a prospective cohort design at Cipto Mangunkusumo General Hospital with total sampling. Patients with malignant tumors of the lower limbs during the period September 2020 to September 2021 were assessed for age, sex, body mass index, tumor type, metastases, pathological fractures, diff count, fibrinogen levels, D-dimer levels, PT rasio, APTT rasio, NLR, PLR and Khorana risk score

Results: Of the 45 study subjects with malignant tumors of the lower limbs, 4 were positive for TVD. From bivariate testing with appropriate statistical tests, there was no significant relationship between patient baseline data such as gender (p= 0.608), BMI (p=0.651), tumor type (p=0.754), pathological fracture (p=0.622), metastases (p=0.679), surgery (p=1,000), tumor location (0.840), venectation (p=0.561), chemotherapy (p=0.617), and Khorana risk score (p=0,552). This study found a significant relationship between the prothrombin time (PT) rasio and the incidence of DVT (P = 0.012). Variables with statistically significant correlation were tumor type (p=0.023) and pathological fracture condition (p=0.026). There was a significant relationship between the venectation variable and the level of D-dimer (p=0.002). There was a significant correlation between D-dimer levels and the Khorana risk factor score (p= 0.035). A significant relationship was found between the pathological fracture variables and the levels of the Platelet-Lymphocyte Rasio (p=0.023). There are 4 variables that are statistically significantly related to the Khorana risk score, namely Hb (p = 0.011), leukocytes (p = 0.005), hematocrit (p = 0.047) and D-dimer (p = 0.035).

Conclusion: The incidence of DVT in malignant tumors of the lower limbs is quite low, namely 8.89%, where there is no statistically significant relationship between characteristic and blood laboratory variables with the incidence of DVT.

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"Leukemia adalah salah satu jenis kanker yang paling banyak ditemukan pada masyarakat perkotaan khususnya pada anak-anak. Tujuan karya ilmiah ini adalah untuk mendeskripsikan asuhan keperawatan pada anak yang menderita leukemia dan optimalisasi perawatan mulut pasca kemoterapi. Berdasarkan pengkajian yang dilakukan pada kasus kelolaan yang terdiagnosis leukemia limfoblastik akut (ALL), didapatkan prioritas masalah keperawatan yaitu ketidakefektifan bersihan jalan napas, kerusakan membran mukosa oral, risiko cedera, dan risiko kekurangan volume cairan. Hasil evaluasi asuhan keperawatan didapatkan bahwa penerapan perawatan mulut berupa menggosok gigi dan berkumur-kumur dengan normal salin (NaCl 0.9%). Perawatan mulut secara teratur dengan normal salin sangat efektif dilakukan dalam mencegah dan mempercepat penyembuhan mukositis. Untuk itu, pendidikan kesehatan dan evaluasi secara rutin terkait perawatan mulut pada anak yang menderita leukemia menjadi penting untuk dilakukan.

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Leukemia is one of the types of cancer which most commonly found in urban communities, especially in children. The purpose of this scientific work is to describe nursing care to child who suffering leukemia and optimization of oral care in post-chemotherapy. Based on the assessment conducted on the management of diagnosed cases with acute lymphoblastic leukemia (ALL), obtained priority nursing problems that are inforced are ineffective airway clearance, oral mucous membrane damage, risk of injury, and risk of lack of fluid volume.

The evaluation results application of nursing showed that implementation of oral care such as teeth brushing and mouth rinsing with normal saline (0.9% NaCl). Regular oral care with normal saline is very effective in preventing and accelerating the healing process the mucositis. Therefore, health education and evaluation are routinely associated oral care in children with leukemia be important to do."