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"Prevalens SNAD NKB < 34 minggu dan atau BLSR di Indonesia masih tinggi. Asuhan antenatal yang tidak adekuat, gejala infeksi saat lahir yang sulit dibedakan dengan prematuritas, dan modalitas diagnostik yang suboptimal membuat diagnosis SNAD pada populasi ini sulit. Presepsin salah satu marker infeksi meningkat saat awal infeksi berpotensi dijadikan salah satu parameter diagnostik SNAD. Tujuan penelitian ini adalah untuk melihat akurasi presepsin sebagai salah satu parameter diagnosis SNAD dan dibandingkan dengan CRP. Studi ini merupakan studi potong lintang terhadap 71 NKB < 34 minggu dan atau BLSR dengan faktor risiko SNAD lebih tinggi atau faktor risiko SNAD rendah yang menunjukkan gejala sepsis di Unit Perinatologi RSCM. Penelitian ini mencari nilai batas presepsin sebagai parameter diagnostik SNAD pada berbagai waktu pengambilan, kemudian membandingkannya dengan CRP. Kurva ROC dikerjakan untuk menentukan nilai batasan optimal presepsin. Penelitian ini mendapat nilai presepsin lebih tinggi pada kelompok SNAD dibandingkan dengan non-sepsis (median 814, 802, dan 693 pg/mL, p<0,05). Presepsin mencapai nilai puncaknya pada T1 sedangkan CRP pada T24. Nilai batas optimal, batas bawah dan batas atas presepsin T1 adalah 621,5, 458, 808 pg/mL. Pada T4 yaitu 733, 518,5, 733 pg/mL serta T24 yaitu 667,5, 556,5, 820,5 pg/mL. Nilai batas presepsin T1 memiliki sensitivitas 82,14%, spesifisitas 81,4%, NDP 74,19%, NDN 87,5%, dan akurasi 81,69%. Sedangkan presepsin T4 memiliki sensitivitas 60,71%, spesifisitas 93,02%, NDP 85%, NDN 78,43% dan akurasi 80,28%. Nilai batasan presepsin T24 memiliki sensitivitas 64%, spesifisitas 86%, NDP 75% dan NDN 78,7% dan akurasi 77,46%. Sebagai kesimpulan, presepsin meningkat sesaat setelah lahir jika terjadi infeksi. Presepsin T1 dapat digunakan sebagai parameter skrining SNAD dengan menggunakan nilai batasan optimal 621,5 pg/mL. Presepsin dengan berbagai nilai batasan tertentu memiliki fungsi yang berbeda dan dapat diaplikasikan ke dalam alur diagnosis dan tata laksana SNAD berdasarkan faktor risiko populasi tersebut.

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Early onset neonatal sepsis prevalence in Indonesia remains high among preterm neonates born at <34 weeks' gestation and or VLBW. Inadequate antenatal care, infectious symptoms at birth that are confusing to distinguish from prematurity, and poor predictive performance of laboratory tests made diagnosis of EOS is wearisome. Presepsin, one of the biomarkers, increases early in onset of infection has potential to become diagnostic tools for EOS. The objective of this study is to find the accuracy of presepsin as one of EOS diagnostic tools and compared it with CRP. This study is a cross-sectional study of of 71 neonates born at < 34 weeks' gestation and or VLBW at higher risk of EOS or at lower risk for EOS that showing some degree of respiratory or systemic instability. Presepsin which was collected in different time interval (T1, T4 and T24), compared to diagnostic criteria of sepsis as the gold standard. The accuracy of CRP with currently cut-off points also analyzed in this study. The ROC curve was performed to determine the optimal cut-off points of presepsin. Presepsin values were higher in the EOS group than in uninfected group at T1(median 814 vs 438 pg/mL; p<0.05) T4 (802 vs 445 pg/mL; p<0.05), and T24 (693 vs 469 pg/ mL; p <0.05). Presepsin achieved best accuracy at T1 and reaches its peak value at T1 while CRP have it at T24. Optimal cut-off points, the lower limit and the upper limit of presepsin at T1 are 621.5, 458, 808 pg/mL. At T4 are 733, 518.5, 733 pg/mL and T24 are 667.5, 556.5, 820.5 pg/mL. With those optimal cut-off value, presepsin has 82.14% sensitivity, 81.4% specificity, 74.19% PPV, 87.5% NPV, and accuracy of 81.69%. Whereas presepsin at T4 has 60.71% sensitivity, 93.02% specificity, 85% PPV, 78.43% NPV and an accuracy of 80.28%. Presepsin at T24 has a sensitivity of 64%, a specificity of 86%, an NDP of 75% and an NDN of 78.7% and an accuracy of 77.46%. In conclusion, presepsin increases shortly after birth in EOS group. Presepsin at T1 can be used as EOS screening tools by using an optimal cut-off value of 621.5 pg/mL. Presepsin with certain boundary values have different functions and perhaps can be applied to the EOS diagnosis and management pathways in RSCM."

"Pendahuluan: C-reactive protein CRP dan procalcitonin PCT merupakan penanda diagnostik dan pemantauan sepsis neonatorum yang paling banyak digunakan. Saat ini terdapat penanda sepsis baru yaitu Soluble CD14 subtype sCD14-ST presepsin. Penelitian ini bertujuan untuk mengetahui manfaat pemeriksaan serial kadar presepsin, CRP dan PCT serta korelasi antara kadar presepsin dengan kadar CRP dan PCT sebagai penanda respons terapi dan prognosis pasien SNAL pada neonatus prematur. Metode: Desain penelitian kohort prospektif. Subjek penelitian terdiri dari 40 neonatus prematur sehat dan 40 pasien neonatus prematur SNAL dan dilakukan pemeriksaan kadar presepsin, CRP dan PCT, selanjutnya dilakukan pemantauan kadar presepsin, CRP dan PCT pasien neonatus prematur SNAL hari ke-3 dan ke-6 setelah diterapi. Pasien neonatus prematur SNAL dikelompokkan menjadi 20 pasien respons terapi dan 20 pasien non respons. Mortalitas pasien neonatus prematur SNAL ditentukan pada pemantauan hari ke-30. Hasil: Median kadar presepsin, CRP dan PCT pada neonatus prematur SNAL masing-masing adalah 1559 pg/mL 427 ndash; 4835 pg/mL, 16.35 mg/L 0.1 ndash; 245.6 dan 4.11 ng/mL 0.17 ndash; 54.18 lebih tinggi secara bermakna dibandingkan pada neonatus prematur sehat 406 pg/mL 195 ndash; 562 pg/mL, 1.22 mg/L 0.1 ndash; 3.69 dan 0.03 0.01 ndash; 0.04 dengan nilai p.

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Introduction: C reactive protein CRP and procalcitonin PCT are marker of neonatal sepsis diagnostics and monitoring of the most widely used. Currently there is a new marker of sepsis that is Soluble CD14 subtype sCD14 ST presepsin. This study aims to determine the benefits of serial presepsin levels, CRP and PCT as well as the correlation between presepsin with CRP and PCT as a marker of response to therapy and prognosis of patients SNAL in premature neonates.

Methods. This was prospective cohort, from 20 healthy preterm neonates and 40 LOS preterm neonates patient. The concentration of presepsin, CRP and PCT were analysed. Presepsin, CRP and PCT measured in both group and in 3rd 6th day sepsis follow up after therapy. Therapeutic respons was done in 20 LOS preterm neonates patient and 20 preterm neonates patient was not. The mortality of LOS preterm neonates patient saw in 30th day observation.

Results: Median of presepsin, CRP and PCT in LOS preterm neonates are 1559 pg mL 427 ndash 4835 pg mL, 16.35 mg L 0.1 ndash 245.6 and 4.11 ng mL 0.17 ndash 54.18, respectively, are significantly higher than healty preterm neonates 406 pg mL 195 ndash 562 pg mL, 1.22 mg L 0.1 ndash 3.69 and 0.03 0.01 ndash 0.04, p value "

"Latar belakang: Persalinan prematur semakin banyak dan memiliki tingkat morbiditas dan mortalitas yang tinggi. Prematur menyumbang angka kematian tertinggi selain asfiksia, infeksi dan kelainan kongenital. Korioamnionitis merupakan salah satu penyebab persalinan prematur dan berhubungan dengan kejadian sepsis neonatal awitan dini pada bayi prematur atau berat lahir rendah. Penelitian dilakukan untuk mengetahui korioamnionitis sebagai prediktor sepsis neonatal awitan dini.Metode : Penelitian kohort prospektif dilakukan bekerja sama dengan Departemen Obstetri dan Ginekologi RSCM dan RSUD Koja. Pengumpulan sampel dilakukan selama periode Maret-September 2022. Dilakukan evaluasi terhadap gejala klinis dan pemeriksaan penunjang ibu yang terkait korioamnionitis, dihubungkan dengan gejala klinis dan pemeriksaan penunjang bayi terkait sepsis neonatal awitan dini yang dirawat di NICU.Hasil : Insidens korioamnionitis sebesar 90% dan sepsis neonatus awitan dini 16%. Jenis persalinan spontan dan section caesarea dengan KPD tidak berhubungan dengan kejadian korioamnionitis (RR:1,049; IK 95% 0,982-1,120; p=1,000) and (RR:1,091; IK 95% 0,967-1,231; p=1,000).Korioamnionitis tidak berhubungan dengan sepsis neonatal awitan dini dengan p=0,358. Demam pada ibu berhubungan dengan kejadian SNAD EONS (RR:3,333: CI 95% 1,399-7,942; p=0,022)Simpulan : Korioamnionitis bukan prediktor sepsis neonatal awitan dini pada bayi usia gestasi ≤32 minggu atau bayi berat lahir ≤ 1500 gram.

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Background: Increasing number of preterm birth correlated with high morbidity and mortality rates. Prematurity contributed in high mortality rates alongside asphyxia, infections and congenital malformations. Chorioamnionitis were associated with preterm birth and early onset sepsis in preterm or low birth weight infants. Research was aimed to determine chorioamnionitis as a predictor of early onset neonatal sepsis (EONS) in preterm or low birth weight.

Methodes : Multicentre, Cohort prospective study conducted in collaboration with Obstetrics and Gynaecology Department of Cipto Mangunkusumo National Hospital (CMH) and Koja General Hospital. Samples were obtained in NICU Unit during March - September 2022. Maternal clinical symptoms and diagnostic tests for chorioamnionitis evaluated as a predictor to early onset neonatal sepsis.

Results : The incidence of chorioamnionitis and early onset neonatal sepsis were 90% and 16% respectively. Spontaneous and caesarean section delivery with PPROM is not associated with the incidence of chorioamnionitis (RR:1,049; CI 95% 0,982-1,120; p=1,000) and (RR:1,091; CI 95% 0,967-1,231; p=1,000). Chorioamnionitis is not a predictor of early onset neonatal sepsis with p=0,358. Maternal fever is associated with the incidence of EONS (RR:3,333: CI 95% 1,399-7,942; p=0,022).

Conclusion : Chorioamnionitis is not a predictor on early onset neonatal sepsis in gestational age ≤32 weeks or birth weight of ≤ 1500 grams."

"Latar Belakang:. Sepsis neonatorum awitan dini masih menjadi penyebab kesakitan dan kematian yang utama pada neonatus, dengan angka lebih tinggi terjadi pada bayi kurang bulan. Berbagai faktor diketahui berhubungan dengan kejadian sepsis neonatorum awitan dini, namun penelitian yang dilakukan pada bayi prematur masih terbatas. Tujuan:. Mengetahui faktor-faktor risiko yang berhubungan dengan kejadian sepsis neonatorum awitan ini pada bayi kurang bulan di RSCM.Metode:. Penelitian desain case-control dengan mengambil data dari rekam medis bayi lahir kurang bulan di RSCM pada rentang waktu Januari 2016-Desember 2017 sebanyak 186 sampel (93 untuk masing-masing kelompok). Data dianalisis secara bivariat dan multivariat.Hasil: Terdapat perbedaan bermakna dari karakteristik bayi kurang bulan antara kelompok kasus dan kontrol yaitu usia gestasi, jenis kelamin laki-laki, dan berat lahir. Gejala klinis tersering ditemukan adalah sesak napas. Dari 7 faktor yang dianalisis, infeksi intrauterin, nilai APGAR 1 menit pertama, dan nilai APGAR 5 menit pertama pada analisis bivariat dimasukkan ke analisis multivariat (p<0,25) sementara pada faktor lainnya tidak ditemukan hubungan yang bermakna. Pada analisis multivariat, ditemukan bahwa jenis kelamin laki-laki, usia gestasi, infeksi intrauterin, dan nilai APGAR 1 menit pertama memiliki hasil yang bermakna secara statistik.Kesimpulan: Jenis kelamin laki-laki, usia gestasi, infeksi intrauterin, dan nilai APGAR 1 menit pertama merupakan faktor risiko independen sepsis neonatorum awitan dini pada bayi kurang bulan. Penelitian lebih lanjut dibutuhkan untuk mengetahui pengaruh faktor-faktor tersebut terhadap kejadian sepsis neonatorum awitan dini pada bayi kurang bulan.

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Background: Early onset neonatal sepsis is still considered as a common cause of morbidity and mortality in neonates, with a higher prevalence found in preterm infants. Many factors are known to be correlating to the cases of early onset neonatal sepsis, but research done specifically in preterm infants is limited.

Objective: To determine the factors associated with early onset neonatal sepsis in preterm infants.

Method: This research was done using a case-control design, where the data is taken from the medical record of preterm patients born in RSCM within January 2016-December 2017. The total sample is 186 (93 for each group). Data was then analyzed using bivariate and multivariate analysis.

Result: A significant result was found in characteristic such as gestational age, gender, and birth weight. Out of 7 factors that were analysed, the factors that were analysed using multivariate analysis were intrauterine infection, low APGAR score in the first minute, and low APGAR score in the fifth minute. From multivariate analysis, gender, gestational age, intrauterine inflammation, and low APGAR score in the first minute were stastically significant.

Conclusion: gender, gestational age, intrauterine inflammation, and low APGAR score in the first minute are independent risk factors for early onset neonatal sepsis. Further study is needed to understand the correlation between those factors and early onset neonatal sepsis in preterm infants."

"ABSTRAK Soluble CD14-ST presepsin merupakan penanda sepsis baru untuk diagnosis dan prognosis sepsis neonatorum. Kadar presepsin meningkat pada keadaan sepsis disebabkan oleh aktivitas protease di fagolisosom. Penelitian ini bertujuan untuk mengetahui manfaat pemeriksaan serial kadar presepsin sebagai penanda pemantauan respons terapi dan prognosis pada pasien SNAL secara bedside dengan menggunakan sampel darah kapiler. Desain penelitian kohort prospektif. Subjek penelitian terdiri dari 20 neonatus sehat dan 42 pasien SNAL. Pemeriksaan kadar presepsin dengan alat Pathfast pada hari ke-1, ke-3, dan ke-6 setelah diterapi. Kadar presepsin pada pasien SNAL 1104 pg/mL (608 ? 6225 pg/mL) lebih tinggi dibandingkan pada neonatus sehat 448 pg/mL (191 ? 513 pg/mL), nilai p 0,000. Pada pasien SNAL kelompok respons terapi kadar presepsin lebih rendah dibandingkan dengan kelompok non respons pada hari ke-3 dan ke-6 (p<0,05). Pada pasien SNAL kelompok non survivor kadar presepsin lebih tinggi dibandingkan dengan kelompok survivor hari ke-6 (p<0,05). Kadar presepsin berkorelasi positif dengan kadar CRP (r=0,488) dan jumlah leukosit (r=0,321). Nilai cut-off kadar presepsin hari ke-6 untuk penentuan prognosis 1365 pg/mL mempunyai AUC 0,789 (IK 95% 0,652 ? 0.926), sensitivitas 90.9%, dan spesifisitas 67,7%. Pemeriksaan presepsin hari ke-3 atau ke-6 secara bedside dengan darah kapiler bermanfaat untuk pemantauan terapi dan prognostik pasien SNAL.ABSTRACT Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient."

"Latar Belakang. Sepsis neonatal awitan dini SNAD masih merupakan masalah di Indonesia. Vitamin D memiliki efek pada fungsi imunitas. Neonatus kurang bulan NKB berisiko mengalami defisiensi kadar vitamin D. Hubungan kadar vitamin D dengan kejadian SNAD pada NKB belum jelas.Tujuan. Menganalisis hubungan kadar vitamin D dengan kejadian SNAD pada NKB.Metode. Duapuluh NKB dengan klinis dan pemeriksaan laboratorium menyokong SNAD kelompok kasus dan 20 NKB tanpa hasil laboratorium SNAD kelompok kontrol ikut dalam penelitian ini. Subjek penelitian adalah NKB usia gestasi ge; 28 sampai dengan < 37 minggu dirawat di RSUPN Cipto Mangunkusumo selama bulan Juli - September 2017. Pemeriksaaan kadar vitamin D 25 OH D dengan metode competitive chemiluminescense immunoassay CLIA direk dengan alat Diasorin Liaison.Hasil. Median kadar vitamin D pada NKB dengan SNAD 8,95 4,10 - 16,30 ng/mL dengan rerata usia gestasi 33,25 1,71 minggu dan rerata berat lahir 1863,75 415,06 gram. Median kadar vitamin D tanpa SNAD 11,75 5,80 - 42,80 ng/mL dengan rerata usia gestasi 34,67 1,53 minggu dan rerata berat lahir 2125,0 340,55 gram. Median kadar vitamin D NKB SNAD lebih rendah secara bermakna dibandingkan NKB tanpa SNAD.

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Background. Early onset neonatal sepsis EONS is still a problem in Indonesia. Vitamin D has effect on immune function. Preterm infants have a risk of deficiency of vitamin D levels. The association between vitamin D levels with EONS were unclear.Objective. To determine the association between vitamin D levels with EONS in preterm infants.Methods. Twenty preterm infants with clinical and laboratory finding of EONS study group and 20 preterm infants with no signs of laboratory infection control group were enrolled this study. The subjects were preterm infants of gestational age ge 28 37 weeks in Cipto Mangunkusumo Hospital during July September 2017. Vitamin D 25 OH D levels were measured using Diasorin Liason with competitive chemilunescence immunoassay CLIA technique.Results. Median vitamin D levels with EONS was 8,95 4,10 16,30 ng mL, mean of gestational age and birth weight were 33,25 1,71 weeks and 1863,75 415,06 g, respectively. Median vitamin D levels without EONS was 11,75 5,80 42,80 ng mL, mean of gestational age and birth weight were 34,67 1,53 weeks and 2125,0 340,55 g, respectively. Median vitamin D levels of preterm infants with EONS was significantly lower than without EONS.Conclusion. Vitamin D levels are associated with EONS in preterm infants."

"Latar belakang: Rekomendasi Centers for Disease Control and Prevention (CDC) 2010 (revisi 2002) tidak spesifik memberi panduan dalam pencegahan sekunder sepsis awitan dini (SAD) pada neonatus cukup bulan (NCB), asimtomatik lahir dari ibu yang mengalami KPD < 18 jam.Tujuan: Didapatnya model determinan SAD pada NCB sesuai masa kehamilan (SMK), asimtomatik lahir dari ibu yang mengalami KPD lebih dari 12 jam.Metodologi: penelitian observasional potong lintang untuk mendapatkan model determinan sepsis neonatorum awitan dini (SNAD) yang dilakukan dari Februari 2013 sampai bulan Mei 2014 di RSAB Harapan Kita, RSUD Tarakan, RSIA Budi Kemuliaan. Determinan yang diteliti adalah jenis persalinan, petanda infeksi saluran kemih (ISK) pada ibu, petanda infeksi intra amnion (IIA) seperti demam intrapartum, ibu takikardia, janin takikardia, adanya perubahan warna dan bau cairan ketuban, leukosit darah ibu, dan petanda infeksi darah tali pusat (peningkatan jumlah total leukosit, neutrofil, peningkatan rasio I/T, hs-CRP dan IL-6). Diagnosis sepsis ditegakkan berdasarkan catatan medis bayi yang dipastikan berdasarkan hasil positif biakan darah tali pusat. Model determinan SNAD yang dihasilkan adalah suatu persamaan regresi logistik yang digunakan untuk menentukan probabilitas terjadinya SNAD sebagai acuan terapi antibiotik.Hasil: model determinan SAD pada NCB SMK, asimtomatik lahir dari ibu KPD > 12 jam berupa kalkulator dan sistem skor yang dibentuk dari determinan persalinan per vaginam, perubahan warna dan bau cairan ketuban, leukosit darah ibu, leukosit darah tali pusat, kadar hs-CRP darah tali pusat dan kadar IL-6 darah tali pusat. Model determinan SNAD memiliki dua varian, varian lengkap digunakan untuk fasilitas pelayanan neonatus subspesialistik dan varian alternatif digunakan untuk fasilitas pelayanan spesialistik. Titik potong ideal penentuan probabilitas terjadinya SNAD memiliki sensitivitas di antara 24,2 – 40,3 % dan spesifisitas 87,1 - 94,5 %. Nilai diskriminasi dengan nilai AUC berkisar di antara 0,743 – 0,816 dengan kalibrasi baik berdasarkan uji Hosmer-Lemeshow.Simpulan: Hasil penelitian ini adalah model determinan SAD pada NCB SMK asimtomatik lahir dari ibu yang mengalami KPD > 12 jam, berbentuk kalkulator dan sistem skor yang memiliki varian lengkap dan alternatif untuk menentukan probabilitas terjadinya SNAD sebagai dasar pemberian terapi antibiotik empiris secara rasional.

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Background: Centers for Disease Control and Prevention (CDC) 2010 (revised 2002) recommendations does not specifically provide guidance in secondary prevention of asymptomatic early-onset sepsis (EOS) on term infant born to mother experiencing PROM < 18 hours.

Objective: to develop early-onset neonatal sepsis (EONS) determinant model as a rational basis for determining the empirical antibiotic therapy in asymptomatic, term infant born to mother with PROM > 12 hours.

Method: A cross-sectional observational study to obtain an EONS determinant model which was conducted from February 2013 to May 2014 in RSAB Harapan Kita, Tarakan Hospital, RSIA Budi Kemuliaan. The determinant factor is the type of delivery, marker of maternal urinary tract infection (UTI), intra-amniotic infection markers (intrapartum fever, maternal tachycardia, fetal tachycardia, change in the color and odor of amniotic fluid, maternal blood leukocytes), and umbilical cord blood infection marker (increased the total number of leukocytes, neutrophils, an increase in the ratio of I / T, hs-CRP and IL-6). Early-onset neonatal sepsis was diagnosed base on infant medical record on 72 hours afeter birth and confirmed by the positive results of umbilical cord blood cultures. The resulting of EONS determinants model is a logistic regression equation used to determine the probability of the occurrence of EONS as reference rational basis empirical antibiotic therapy.

Results: The EOS determinants model on asymptomatic term infant born to mothers with PROM> 12 hours is a calculator and scoring system that is formed from the determinant of vaginal delivery, change the color and odor of amniotic fluid, maternal blood leukocytes, cord blood leukocytes, the levels of hs-CRP and IL-6 umbilical cord blood level. Early-onset neonatal sepsis determinant model has two variants, the full variant used for subspecialty neonatal care facilities and alternative variant is used for specialty neonatal care facilities. Ideal cutoff point probability of occurrence SNAD has sensitivity range of 24.2 to 40.3% and specificity of 87.1 to 94.5%. The model performe is good based on Hosmer-Lemeshow test anda discrimination value AUC in in range of 0.743 to 0.816.

Conclusion: The EOS determinant model of asymptomatic term infant born to mothers with PROM > 12 hours is a calculator and scoring system that is used to determine the probability of EONS occurrence as the basis of determining the rational empirical antibiotic therapy."

"ABSTRAKPasien kanker serviks yang mendapatkan kemoterapi akan mengalami masalahsecara fisik maupun psikologis. Keluhan fisik seperti mual, muntah dan lemah lesuserta respon psikologis seperti kecemasan dan depresi dapat dikurangi denganmemberikan paket edukasi tentang perawatan diri selama di rumah. Di ruangkandungan RSU Dr. Soetomo Surabaya telah dikembangkan paket edukasi yangberisi tentang pengaturan nutrisi, aktivitas, aspek psikologis dan latihan relaksasiotot progresif yang diberikan pada pasien kanker serviks yang menjalani kemoterapi.Tujuan dari studi ini adalah untuk mengetahui hubungan paket edukasi dengankeluhan fisik dan psikologis pada pasien kanker serviks yang menjalani kemoterapi.Penelitian ini menggunkan desain cross sectional. Metode sampling yang digunakanadalah total populasi. Sampel diambil sesuai dengan kriteria inklusi sejumlah 25orang. Data dikumpulkan dengan menggunakan kuesioner. Data analisis denganmenggunakan uji T dan chi-squere. Hasil menunjukan adanya perbedaan yangbemakna tingkat keluhan mual muntah, lemah lesu dan respon psikologis padaresponden sebelum dan sesudah intervensi (p<0,05). Hasil analisis hubungankarakteristik responden dengan keluhan didapatkan hasil ada hubungan antara umurdengan kecemasan (P=0,032), ada hubungan antara status bekerja dengankecemasan (P=0,003) dan ada hubungan antara frekuensi kemoterapi dengan lemahlesu (P=0,015). Implikasi dari hasil penelitian ini adalah dapat dikembangkannyapaket edukasi sebagai bagian dari asuhan keperawatan pada pasien kanker serviksyang menjalani kemoterapi untuk menurunkan keluhan fisik dan psikologis sehinggamemiliki kualitas hidup yang lebih baik.

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ABSTRACTIn general cervical cancer patient who undergo chemotherapy will experience physical and psychological symptoms. Physical symptoms such as nausea, vomiting, and fatigue; and psychological symptoms such as anxiety and depression can be minimized by giving them education package on how implement self-care at home. In the obstetric-gynecologic ward Dr. Soetomo hospital, education package on nutrition, physical exercise, psychological aspect and progressive muscle relaxation exercise had been established for cervical cancer patient who undergone chemotherapy. The purpose of this study is to examine the relationship between education package given to the cervical cancer patient with the physical and psychological symptoms on cervical cancer who undergone chemotherapy. This study was using cross sectional design with total population sampling method. 25 samples were recruited based on the inclusion criteria using structured questionnaire. T-test and chi-square were used to analyze the data. The findings shows that there is a significant different on nausea, vomiting & fatigue symptoms and psychological symptoms before and after intervention (p<0,05). The other findings show that there was a relationship between respondent characteristics and symptoms: aged and level of anxiety (P=0.032); work status & anxiety (P=0.003); and chemotherapy frequency & fatigue (P=0.015). The implication of this study was that education package is part of the nursing care of cervical cancer patient who undergone chemotherapy which can minimize physical & psychological symptoms and improve patient’s quality of life."

"Kanker ovarium merupakan kanker ke tujuh yang paling sering ditemukan di seluruh dunia setelah kanker payudara, serviks, kolorektal, lambung, korpus uteri dan paru. Menurut data histopatologi tahun 1996, karsinoma ovarium menunjukkan urutan ketiga setelah karsinoma serviks dan karsinoma payudara.Insiden kanker ovarium di Amerika Serikat (AS) berkisar antara 15,7 dari 100.000 wanita kelompok usia 40-44 tahun hingga 54 dalam 100.000 wanita kelompok usia 75-79 tahun. Di Australia, insiden kanker ovarium sebesar 11,8 dalam 100.000 wanita. Kanker ovarium cukup membingungkan karena inaidennya meningkat seiring dengan meningkatnya angka kematian selama beberapa dekade terakhir.Gejala Minis yang tidal( spesifik pada stadium dini the International Federation of Gynecology and Obstetrics (FIGO), maupun keterlambatan dalam merujuk pasien rnenyebabkan banyak kasus yang datang pada stadium lanjut. Pada saat didiagnosis, lebih dari 60% kanker ovarium menunjukkan stadium lanjut dan prognosisnya buruk dengan perkiraan ketahanan hidup 5 tahun berkisar 10-20%. Di Norwegia, sekitar 480 insiden kasus baru didiagnosis setiap tahunnya, dan sekitar duapertiga pasien mengalami kekambuhan penyakit, yang terbukti berakibat fatal.Keganasan ovarium terjadi pada semua umur. Angka morbiditas meningkat hingga mencapai usia 70 tahun, kemudian menurun kembali. Waktu kritis adalah sekitar usia 40 tahun morbiditas meningkat secara dramatis.Terdapat beberapa tulisan mengenai faktor prognostik pada pasien dengan kanker ovarium dan banyak peneliti menekankan pentingnya faktor-faktor ini untuk perencanaan dan hasil akhir pengobatan. Penelitian-penelitian yang dilakukan biasanya berbasis populasi, maupun rumah sakit. Sebagian peneliti menggunakan sampel kanker ovarium secara keseluruhan sementara sebagian lainnya menggunakan sampel karsinoma ovarium."

"Tujuan: Penelitian ini bertujuan membandingkan kejadian retensio pada pasien kanker serviks yang menjalani histerektomi radikal dengan dan tanpa teknik nerve sparingMetode: Pasien kanker serviks stadium IB-IIA yang menjalani prosedur histerektomi radikal di Rumah Sakit Cipto Mangunkusumo periode Juni 2011 hingga Mei 2012 masuk sebagai subjek penelitian. Kelompok terbagi menjadi kelompok dengan dan tanpa teknik nerve sparing. Pencatatan morbiditas intraoperatif serta analisa residu urin serta kejadian retensio urin pascaoperasi menjadi keluaran penelitian. Analisis statistik menggunakan uji Fisher, Chi-Square dan uji T tidak berpasangan.Hasil: Sebanyak 39 pasien kanker serviks menjalani prosedur histerektomi radikal dalam periode penelitian. Dari sejumlah tersebut, hanya 26 pasien yang dapat dianalisa. Tujuh belas subjek dengan teknik nerve sparing dan sembilan subjek tanpa nerve sparing. Tidak ada perbedaan karakteristik pasien dalam hal jenis histopatologi maupun stadium kanker serviks. Morbiditas intraoperatif tidak berbeda antar kelompok dari segi: lama operasi (307 menit VS 300 menit, p 0.76), jumlah perdarahan (1340 ml VS 1044 ml, p 0.41) serta komplikasi intraoperatif (p 1.00). Meskipun tidak berbeda secara statistik, terdapat kecenderungan nilai volume miksi lebih banyak pada kelompok dengan nerve sparing satu bulan pascaoperasi. Volume residu urin pada satu bulan pascaoperasi lebih sedikit pada kelompok dengan nerve sparing (78 ml VS 310 ml, p 0.03). Kesimpulan: Terdapat perbedaan bermakna volume residu urin satu bulan pasca operasi antara kelompok dengan dan tanpa nerve sparing.

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Objectives: To describe the efficacy of nerve sparing during radical hysterectomy technique in reducing post operative urinary retention in our institution.Methods: Cervical cancer patients stage IB-IIA whom underwent radical hysterectomy procedure at Cipto Mangunkusumo Hosptal from June 2011 till May 2012 were considered into the study. Study group was divided into group with and without nerve sparing technique. Intraoperative morbidity, residual urine volume and incidence of urinary retention were our outcomes. We used Fisher test, Chi Square test and Independent sample T Test for statistical analysis.Results: A total of 39 patients underwent radical hysterectomy procedure during the time period. From there, as much as 26 patients were available for analysis with 17 subjects underwent nerve sparing and 9 subjects without nerve sparing. No difference found between study group in terms of histopathology and stadium. Intraoperative morbidity such as length of operation (307 min VS 300 min, p value 0.76), bleeding (1340 mL VS 1044 mL, p value 0.41) and intraoperative complication did not differ between groups (p value 1.00).Though not statistically significant, there is a tendency of higher micturition volume in nerve sparing group at day 30th postoperative. Residual urine volume at one month postoperative was lower in nerve sparing group (78 ml VS 310 ml, p value 0.03). Conclusion: Difference in residual urine volume one month postoperative was found between group with and without nerve sparing technique."