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"Latar Belakang: Retinoblastoma adalah keganasan intraokular paling sering dan juga salah satu tumor padat tersering pada anak-anak. Di negara berkembang dimana terdapat perawatan dan deteksi dini yang baik, prognosis umumnya baik dengan tingkat kesintasan tinggi. Sayangnya, di negara berkembang termasuk Indonesia diagnosis umumnya tertunda dan kesintasan masih rendah. Hitung darah lengkap merupakan uji yang secara relative mudah dan murah serta dikatakan dapat memberikan informasi prognostik yang bernilai dan membantu menilai kesintasan pada berbagai jenis kanker. Namun, studi mengenai hal tersebut masih sangat sedikit pada kasus retinoblastoma. Tujuan: Penelitian ini bertujuan untuk mengidentifikasi hubungan antara profil darah tepi pada presentasi awal dan kesintasan pada retinoblastoma. Metode: Penelitian ini menggunakan desain potong lintang retrospektif dengan cara mengumpulkan rekam medis pasien retinoblastoma yang didiagnosis sejak Januari 2011 sampai Desember 2013 di Rumah Sakit Ibu dan Anak Cipto Mangunkusumo 'Kiara'. Demografi dan profil klinis pasien dikumpulkan dan keluaran dikategorikan menjadi event mati dan censored tidak mati . Analisis kesintasan dilakukan menggunakan metode Kaplan Meier dengan SPSS. Hasil: Analsis survival dengan metode Kaplan-Meier dan log-rank test menunjukkan tidak ada perbedaan signifikan antar kesintasan pasien, baik berdasarkan status hemoglobin p=0,219 , status leukosit p=0,903 , dan status trombosit p=0,649 sebelum menerima terapi sistemik. Namun demikian, terlihat ada trend kesintasan.

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Background: Retinoblastoma is the most common intraocular malignancy and is also one of the most common solid tumors in children. In developed countries where treatment is good and early detection is available, the prognosis and survival is good. Unfortunately, in developing countries including Indonesia diagnosis is still often delayed and survival is still low. Complete blood count as a relatively accessible and affordable test has been studied to provide valuable prognostic information and help in assessing the survival in various types of cancers. However, such studies is still very limited in retinoblastoma cases.

Objectives: This study aims to identify the relation between peripheral blood profile on first presentation and survival in retinoblastoma.

Methods: This study uses retrospective cross sectional study design by collecting medical records of retinoblastoma patients diagnosed from January 2011 to December 2013 in Cipto Mangunkusumo Children and Maternal Hospital 'Kiara'. The demography and clinical profile of patients is collected and outcome is categorized into event dead and censored not dead. Survival analysis is done using Kaplan Meier with SPSS.

Results: Survival analysis using Kaplan Meier method and log rank test shows no significant difference in survival between patients, either according to hemoglobin status p 0,219 , leukocyte status p 0,903 , and thrombocyte status p 0,649 before receiving systemic therapy. Nevertheless, there seem to be a trend of lower mean survival in group with abnormal Hb and leukocyte, although such relation is not seen in thrombocyte.Conclusion Although there is no significant relation, there seem to be a trend in which patients with worse peripheral blood profile has worse survival."

"Gangguan rasa nyaman adalah perasaan kurang senang, lega dan sempurna dalam dimensi fisik, psikospiritual, lingkungan dan sosial. Perawat perlu menggunakan beberapa metode dalam mengurangi ketidaknyamanan anak saat di rumah sakit agar tidak memberikan dampak negatif dan trauma dimasa yang akan datang. Tujuan karya tulis ilmiah ini adalah untuk menganalisis penerapan Teori Comfort Kolcaba dalam proses asuhan keperawatan pada anak dengan masalah gangguan rasa nayaman. Metode karya ilmiah ini adalah studi kasus. Terdapat lima kasus anak di ruang IGD anak zona kuning yang diberikan asuhan keperawatan dengan pendekatan Teori Comfort Kolcaba. Aplikasi Comfort Kolcaba membagi tingkat kenyamanan dalam empat konteks yaitu kenyamanan fisik, psikospiritual, lingkungan dan sosiokultural. Intervensi keperawatan yang dilakukan adalah berdasarkan pendekatan berbasis bukti seperti distraksi, modifikasi lingkungan dan keterlibatan keluarga untuk meningkatkan kenyamanan anak. Penggunaan skerem bermotif kartun terbukti kurang efektif dalam menurunkan kecemasan anak saat dilakukan prosedur penusukan vena.

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Comfort disorders is feeling less happy, relieved, and perfect in physical, psychospiritual, environmental, and social dimensions. Nurses need to use several ways to reduce the child's discomfort while in hospital so that it does not have a negative impact and trauma in the future. The purpose of scientific writing is to analyze the application of Kolcaba's Comfort Theory in the nursing care process for children with comfort problems. The method of this scientific work is a case study. There are five cases of children in the yellow zone children's ER who were given nursing care with the Kolcaba Comfort Theory approach. The Comfort Kolcaba application divides the comfort level into four contexts: physical comfort, psychospiritual, environmental, and socio-cultural. Nursing interventions that are carried out are based on evidence-based approaches such as distraction, environmental modification, and family involvement to increase child comfort. The use of cartoon-patterned series proved to be less effective in reducing children's anxiety during the venipuncture procedure."

"[ABSTRAKLatar belakang. Komponen darah washed erythrocyte (WE) mempunyai fungsi yang sama dengan leukodepleted PRC (LD-PRC) yaitu untuk mencegah atau mengurangi reaksi transfusi. Namun banyak kekhawatiran para klinisi tentang cara pembuatan komponen darah WE dan bahan yang terkandung pada filter leukosit untuk menangkap leukosit. Tujuan utama dari penelitian ini adalah memberikan bukti secara ilmiah akan keamanan dalam pemakaian komponen darah PRC yang telah dimodifikasi ini dan juga memberikan pemahaman tentang pemakaian yang benar untuk komponen darah ini. Metoda. Penelitian ini menggunakan desain potong lintang pada 52 sampel darah. Pemeriksaan darah dilakukan pada 26 sampel WE sebelum dan sesudah menjadi komponen darah WE dan 26 sampel LD-PRC sebelum dan sesudah menjadi komponen darah LD-PRC. Pemeriksaan hematologi diperiksa secara otomatis menggunakan Sysmex Xn-2000, total protein diperkirakan menggunakan ADVIA 1650/1800, sedangkan hemolisis darah diamati menggunakan uji Osmotic Fragility Test (OFT). Hasil. Menunjukan kadar hemoglobin pada kelompok WE berkurang 15,4%, volume hematokrit menurun 8,55%, kadar protein menurun 98,4 %, dan jumlah leukosit menurun 87,31% dibandingkan dengan kelompok PRC sebelum dicuci. Selain itu, kadar hemoglobin dari komponen darah leukodepleted menurun 29,1%, volume hematokrit meningkat 21%, kadar protein menurun 79,1% dan jumlah leukosit menurun 99,9% dibandingkan dengan kelompok WB sebelum dijadikan komponen leukodepleted PRC. Persentase hemolisis pada komponen darah WE dan LD-PRC adalah < 0,8% Perbedaan bermakna komponen darah WE dan LD-PRC dapat diamati pada parameter penilaian protein sisa dan leukosit sisa (p<0,05). Simpulan. Dalam pembuatan komponen darah WE protein plasma berkurang sebanyak 98,4%, sedangkan dalam pembuatan leukodepleted PRC, jumlah leukosit berkurang sebanyak 99,97%. Terjadinya hemolisis dapat diabaikan karena pada kedua komponen darah, hemolisis terjadi < 0,8%. Jika diperlukan komponen darah dengan kandungan protein plasma yang sedikit dapat digunakan komponen darah WE, sementara itu jika diperlukan komponen darah dengan jumlah leukositnya sedikit dapat digunakan/dipilih komponen darah leukodepleted.

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ABSTRACTBackground. Washed erythrocyte (WE) and leukodepleted erythrocyte (LD-PRC) are normally used in clinical transfusion to prevent transfusion reaction. However, clinicians are wondering on the safety of those two blood components. The open system with saline for erythrocyte washing and the use of filter for blood leukodepletion still leave quiries on the possibility of hemolysis and their effectiveness for clinical transfusion. This study aims to provide scientific reasoning and the appropriate use of WE and leukodepleted blood respectively. Methods. A cross sectional approach was employed in this study on two groups of blood component consisting of 52 blood samples each , i.e. WE and LD-PRC respectively. Blood examinations were carried out on 26 WE samples prior to and after washing and on 26 LD-PRC samples prior to and after leukodepletion. Blood indices were examined automatically using Sysmex Xn-2000, total protein was estimated using ADVIA 1650/1800, while blood hemolysis was observed employing Osmotic Fragility Test (OFT). Results. It was shown that hemoglobin concentration of WE group decreased by 15.4%, hematocrit volume decreased by 8.55%, protein concentration decreased by 98.4%, and leukocyte count decreased by 87.3% compared to those the original Packed Red Cells. In addition, it was shown that the hemoglobin concentration of the leucodepleted blood component decreased by 29.1%, hematocrit volume increased by 21%, protein concentrations decreased 79.1% and the leukocyte count decreased by 99.9%. All the sampel of the WE blood products and all the LD-PRC blood sampel has hemolysis level <0,8% However, a significant difference in protein concentration and leukocyte count was observed betwen WE and LD-PRC (p<0.05). Conclusion. The process of erythrocytes? washing decreased the plasma protein concentration by 98.4%, whilst the process of leucodepletion decreased the leucocyte count by 99.97%. Hemolysis during the preparation of both blood components could be negligible. It is concluded that WE blood component is preferable for transfusion when low plasma protein is required. On the other hand, leukodepleted PRC is preferable when blood component with low in leucocyte count is required.;Background. Washed erythrocyte (WE) and leukodepleted erythrocyte (LD-PRC) are normally used in clinical transfusion to prevent transfusion reaction. However, clinicians are wondering on the safety of those two blood components. The open system with saline for erythrocyte washing and the use of filter for blood leukodepletion still leave quiries on the possibility of hemolysis and their effectiveness for clinical transfusion. This study aims to provide scientific reasoning and the appropriate use of WE and leukodepleted blood respectively. Methods. A cross sectional approach was employed in this study on two groups of blood component consisting of 52 blood samples each , i.e. WE and LD-PRC respectively. Blood examinations were carried out on 26 WE samples prior to and after washing and on 26 LD-PRC samples prior to and after leukodepletion. Blood indices were examined automatically using Sysmex Xn-2000, total protein was estimated using ADVIA 1650/1800, while blood hemolysis was observed employing Osmotic Fragility Test (OFT). Results. It was shown that hemoglobin concentration of WE group decreased by 15.4%, hematocrit volume decreased by 8.55%, protein concentration decreased by 98.4%, and leukocyte count decreased by 87.3% compared to those the original Packed Red Cells. In addition, it was shown that the hemoglobin concentration of the leucodepleted blood component decreased by 29.1%, hematocrit volume increased by 21%, protein concentrations decreased 79.1% and the leukocyte count decreased by 99.9%. All the sampel of the WE blood products and all the LD-PRC blood sampel has hemolysis level <0,8% However, a significant difference in protein concentration and leukocyte count was observed betwen WE and LD-PRC (p<0.05). Conclusion. The process of erythrocytes’ washing decreased the plasma protein concentration by 98.4%, whilst the process of leucodepletion decreased the leucocyte count by 99.97%. Hemolysis during the preparation of both blood components could be negligible. It is concluded that WE blood component is preferable for transfusion when low plasma protein is required. On the other hand, leukodepleted PRC is preferable when blood component with low in leucocyte count is required., Background. Washed erythrocyte (WE) and leukodepleted erythrocyte (LD-PRC) are normally used in clinical transfusion to prevent transfusion reaction. However, clinicians are wondering on the safety of those two blood components. The open system with saline for erythrocyte washing and the use of filter for blood leukodepletion still leave quiries on the possibility of hemolysis and their effectiveness for clinical transfusion. This study aims to provide scientific reasoning and the appropriate use of WE and leukodepleted blood respectively. Methods. A cross sectional approach was employed in this study on two groups of blood component consisting of 52 blood samples each , i.e. WE and LD-PRC respectively. Blood examinations were carried out on 26 WE samples prior to and after washing and on 26 LD-PRC samples prior to and after leukodepletion. Blood indices were examined automatically using Sysmex Xn-2000, total protein was estimated using ADVIA 1650/1800, while blood hemolysis was observed employing Osmotic Fragility Test (OFT). Results. It was shown that hemoglobin concentration of WE group decreased by 15.4%, hematocrit volume decreased by 8.55%, protein concentration decreased by 98.4%, and leukocyte count decreased by 87.3% compared to those the original Packed Red Cells. In addition, it was shown that the hemoglobin concentration of the leucodepleted blood component decreased by 29.1%, hematocrit volume increased by 21%, protein concentrations decreased 79.1% and the leukocyte count decreased by 99.9%. All the sampel of the WE blood products and all the LD-PRC blood sampel has hemolysis level <0,8% However, a significant difference in protein concentration and leukocyte count was observed betwen WE and LD-PRC (p<0.05). Conclusion. The process of erythrocytes’ washing decreased the plasma protein concentration by 98.4%, whilst the process of leucodepletion decreased the leucocyte count by 99.97%. Hemolysis during the preparation of both blood components could be negligible. It is concluded that WE blood component is preferable for transfusion when low plasma protein is required. On the other hand, leukodepleted PRC is preferable when blood component with low in leucocyte count is required.]"

"Summary: Branna O'Dwyer has a rich and remarkable life. Her little shop in County Mayo is thriving and her close circle of friends and family have found love and happiness. But Branna's own heart remains closed - to protect herself and the man she loves from a terrible threat. She reached out once to Finbar Burke - and it almost destroyed them both. Fin and Branna have both inherited a gift for magic, but Fin shares his blood with an old and terrible enemy. And so the two friends have kept their distance, both secretly yearning for the impossible. That distance has kept them safe - and unhappy. But as a final battle draws close, Branna and Fin are brought irresistibly together. And while they succumb to the heat between them, there can be no promises for tomorro"