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"Latar belakang: Tumor otak primer dan sekunder memiliki patofisiologi dan pendekatan diagnosis yang berbeda. Keganasan dapat menyebabkan status gizi kurang, namun hal tersebut belum diketahui pada tumor otak primer, terutama bila dibandingkan tumor otak sekunder.Metode penelitian: Studi potong lintang pada penderita tumor otak primer dan sekunder di RSUPN Cipto Mangunkusumo tahun 2017-2019. Diagnosis malnutrisi menggunakan kriteria GLIM (Global Leadership Initiative on Malnutrition). Analisis data menggunakan Chi Square/Fisher dan multivariat regresi logistik.Hasil: Terdapat 333 subjek: 246 tumor otak primer dan 87 sekunder. Gambaran status gizi penderita tumor otak primer: 47,6% obesitas; 6,1% malnutrisi; sisanya normal, sedangkan pada tumor otak sekunder: 25,3% malnutrisi; 24,1% obesitas; sisanya normal. Tumor otak sekunder berisiko malnutrisi dengan RR 1,257 (KI 95% 1,108-1,426), p<0,001. Faktor-faktor yang memengaruhi malnutrisi adalah jenis tumor otak primer/sekunder, jenis kelamin, usia, penurunan kesadaran, anoreksia, keluhan gastrointestinal, lesi intraaksial, lesi multipel, dan lokasi lesi yang melibatkan lobus frontal. Faktor yang berhubungan secara independen adalah lesi multipel dengan aOR 3,423 (KI 95% 1,124-10,426), p 0,03.Kesimpulan: Status gizi penderita tumor otak primer dan sekunder berbeda, dengan tingkat malnutrisi yang lebih tinggi pada tumor otak sekunder dan obesitas yang tinggi pada tumor otak primer. Jumlah lesi multipel di otak memengaruhi terjadinya malnutrisi.

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Background: Primary and secondary brain tumors have different pathophysiologies and diagnostic approaches. Malignancy can cause poor nutritional status, but it is not yet known in primary brain tumors, especially when compared to secondary brain tumors.

Method: Cross-sectional study in patients with primary and secondary brain tumors at Cipto Mangunkusumo General Hospital in 2017-2019. Malnutrition was diagnosed using the GLIM (Global Leadership Initiative on Malnutrition) criteria. Data analysis used Chi Square/Fisher and multivariate logistic regression.

Results: There were 333 subjects: 246 primary and 87 secondary brain tumors. Description of nutritional status of patients with primary brain tumors: 47.6% obese; 6.1% malnutrition; the rest were normal, while in secondary brain tumors: 25.3% were malnourished; 24.1% obese; the rest is normal. Secondary brain tumor at risk of malnutrition with RR 1.257 (95% KI 1.108-1.426), p<0.001. Factors influencing malnutrition were the type of primary/secondary brain tumor, gender, age, decreased consciousness, anorexia, gastrointestinal complaints, intraaxial lesions, multiple lesions, and the location of the lesions involving the frontal lobes. The independently related factor was multiple lesions with an aOR of 3,423 (95% KI 1.124-10.426), p 0.03.

Conclusion: The nutritional status of patients with primary and secondary brain tumors is different, with higher levels of malnutrition in secondary brain tumors and higher obesity in primary brain tumors. The number of multiple lesions in the brain affects the occurrence of malnutrition."

"Pendahuluan: Kejang pascaoperasi merupakan salah satu komplikasi pascakraniotomi tumor. Prevalensinya antara 4 - 20%, dan paling banyak muncul satu minggu pascaoperasi. Penambahan obat fenitoin pada pemberian obat levetiracetam untuk mengendalikan kejang pascaoperasi belum pernah ditelilti. Tujuan: Untuk mengetahui apakah terdapat perbedaan antara kelompok yang mendapatkan levetiracetam dengan dan tanpa penambahan fenitoin dalam hal kejadian kejang pascaoperasi, efek samping, peningkatan dosis steroid, serta gambaran faktor risiko kejang pascaoperasi. Metode: Penelitian ini merupakan penelitian pendahuluan menggunakan metode uji klinis. Pasien dirandomisasi dan dikelompokkan menjadi kelompok yang mendapatkan levetiracetam saja dan levetiracetam dengan fenitoin. Diobervasi selama 7 hari pascaoperasi, apakah terdapat kejang, efek samping, dan peningkatan dosis steroid. Pada kelompok yang mendapatkan fenitoin, kadar fenitoin dalam darah diukur pada hari ke-7. Hasil: Manfaat penambahan fenitoin pada pemberian levetiracetam masih belum bisa dinilai karena jumlah sampel masih sedikit. Efek samping lebih banyak ditemukan pada kelompok yang mendapatkan penambahan fenitoin.

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Introduction: Postoperative seizure is one of complications of brain tumor surgery. Prevalence is 4-20% and mostly occurred in the first postoperative week. The beneficial of giving add on phenytoin to levetiracetam has never been studied before.

Aims: To determine the difference of postoperative seizure incidence, side effect, elevation of steroid dose, and risk factors profile in both groups, the levetiracetam group and levetiracetam with add on phenytoin group.

Methods: This is a pilot study with clinical trial design. Patients were randomized and allocated into two groups, levetiracetam group and levetiracetam with add on phenytoin group. Observation was done in 7 postoperative days. Any incidence of postoperative seizures, drug side effects, and elevation of steroid dose was noted. In group receiving phenyotin, the blood level of phenytoin was measured on the 7th day.

Result: The benefit of add on phenytoin to levetiracetam therapy for postoperative seizure in brain tumor patients could not be evaluated due to small sample size. More drug related side effects were found on group receiving phenytoin."

"Pasien dengan kasus tumor otak memerlukan perawatan yang komprehensif dan membutuhkan waktu yang lama untuk pasien dapat beradaptasi dengan perubahan-perubahan yang terjadi pada dirinya. Selama pasien menjalani masa perawatan di rumah sakit, asuhan keperawatan yang tepat diberikan kepada pasien adalah dengan model konsep teori adaptasi Roy. Asuhan dengan pendekatan model adaptasi ini menjadi pilihan yang sesuai untuk kasus-kasus perawatan jangka panjang sehingga pasien dapat menjalani kehidupan lanjutan pasca perawatan dengan baik, mengembalikan kemandirian, kepercayaan diri terutama konsep gambaran diri dan status peran di masyarakat. Perawat dengan pendidikan spesialis harus mampu menjalankan berbagai peran terutama sebagai Clinical Care Manager, dengan demikian peningkatan layanan keperawatan di rumah sakit dapat dicapai dengan lebih optimal dan memberikan kepuasan pelanggan. Laporan analisis praktek ini membahas mengenai asuhan keperawatan perioperative pada pasien dengan tumor otak, laporan praktik keperawatan berbasis fakta yaitu early mobilization dan resume pasien dengan gangguan neurologis di RS PON Jakarta,serta e handbook peran perawat perioperative dalam pembedahan spinal. Analisis praktik residensi ini dapat digunakan sebagai dasar perawat dalam latihan critical thinking, mengelola kasus sulit dan menerapkan asuhan keperawatan berbasis bukti.

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Patients with cases of brain tumor require comprehensive care and require a long time for the patient to adapt of the changes that occur. As long as the patient is undergoing treatment in the hospital, the appropriate nursing care is using Roy's adaptation teori concept model. Adaptation model approach is an appropriate choice for cases of long-term care so that patients can live a good post- treatment follow-up life, restore independence, self-confidence, especially the concept of self-image and role status in society. Nurses with specialist education must be able to carry out various roles, especially as Clinical Care Managers, thus improving nursing services in hospitals can be achieved more optimally and provide customer satisfaction. This practice analysis report discusses perioperative nursing care for patients with brain tumor, a fact-based nursing practice report, namely and resumes of patients early mobilization with neurological disorders at National brain centre Hospital Jakarta. E handbook about perioperative nursing at spinal surgery. This residency practice analysis can be used as a basis for nurses in critical thinking exercises, managing difficult cases and implementing evidence-based nursing care. Keywords: Brain tumor, Roy's adaptation model, early mobilization, E handbook about perioperative nursing at spinal surgery."

"Malnutrisi sering ditemukan pada pasien pasca bedah dan berhubungan dengan penurunan fungsi otot, respirasi, imun serta terganggunya penyembuhan luka. Penelitian observasional analitik ini bertujuan mengetahui faktor yang mempengaruhi status nutrisi akut pascabedah. Dilakukan pemeriksaan kadar retinol binding protein (RBP) hari ke-1 dan ke-5 pasca bedah sebagai indikator status nutrisi akut. Asupan nutrisi dan prosentasenya terhadap resting energy expenditure (REE) diukur tiap hari. Dilakukan pemeriksaan kortisol dan C-reactive protein (CRP) sebagai marker respons inflamasi. Dari 35 subyek penelitian sesuai kriteria inklusi disimpulkan kadar RBP hari ke-1, kortisol dan CRP berpengaruh terhadap status nutrisi akut pascabedah.

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Malnutrition is common in postoperative patients and is associated with decreased muscle function, respiratory, immune and disruption of wound healing. This analytic observational study aims to determine the factors that affect the nutritional status of acute post operative patients. We examined the levels of retinol binding protein (RBP) on day 1 and 5 post-operative as an indicator of acute nutritional status. Nutrient intake was calculated for each day and the percentage from resting energy expenditure (REE). We also examined cortisol and C-reactive protein (CRP) as markers of inflammatory response. Of the 35 study subjects who met the inclusion criteria, we can conclude that RBP levels, cortisol and CRP in day 1 are indicators of acute post-operative malnutrition"

"Latar Belakang: Penolakan cangkok akut pascatransplantasi hati anak dapat berakibat cangkok tidak berfungsi. Angka kejadian yang mencapai 31% di Rumah Sakit Cipto Mangunkusumo (RSCM) membutuhkan evaluasi faktor risiko untuk mengurangi morbiditas dan mortalitas. Metode: Rekam medis 44 resipien anak pascatransplantasi hati donor hidup dari tahun 2010-Januari 2020 dievaluasi, dan dianalisa menggunakan fisher test. Hasil: Sebelas subjek (25%) mengalami penolakan cangkok akut pascatransplantasi dengan median waktu 12 hari (jarak waktu 6-70 hari) pascatransplantasi. Total 44 subjek, 29 (65,9%) berusia > 1 tahun dan 30 (68,1%) bergizi kurang. Kejadian penolakan cangkok akut pada kelompok usia ≤1 tahun, adalah 5 (33%) dan pada usia >1 tahun, 6 (20%). Penolakan cangkok akut terjadi pada 6 subjek (20%) dengan gizi kurang, dan 5 subjek (35,7%) dengan gizi baik. Hasil analisa menunjukkan tidak ada hubungan antara usia (p= 0,468; 95% CI 0,47-0,77; OR 1,917) dan status gizi (p=0,287; 95% CI 0,11- 1,85; OR 0,450) terhadap reaksi penolakan cangkok akut pascatransplantasi hati donor hidup anak di RSCM. Hasil observasi tiga bulan pertama memperlihatkan rerata kadar tacrolimus darah 6-8 ng/mL pada hari 12-15, tidak mencapai target untuk mendapatkan efek imunosupresi yang adekuat. Kesimpulan: Pada penelitian ini status gizi kurang dan usia resipien saat transplantasi hati tidak signifikan sebagai faktor risiko independen reaksi penolakan cangkok akut, tetapi dapat dipikirkan bahwa kedua faktor ini mempengaruhi imunitas resipien, yang selanjutnya berperan dalam reaksi penolakan cangkok akut. Penggunaan imunosupresan yang adekuat juga harus diperhatikan dalam menekan reaksi penolakan cangkok pascatransplantasi hati.

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Background: Acute rejection post-liver transplant in children may result in graft failure. The incidence rate of up to 31% at Cipto Mangunkusumo Hospital (RSCM) needs further evaluation of risk factors to lower morbidity and mortality.

Methods: 44 medical records of post living donor liver transplant pediatric recipients between 2010 until January 2020 were evaluated and analyzed using Fisher’s test.

Results: Eleven subjects (25%) were found to experience acute rejection post-transplant with a median time of 12 days (range 6-70 days) after surgery. Of the 44 recipients, 29 subjects (65,9%) were >1 year old and 30 subjects (68,1%) were undernourished. Acute rejection occurred in 5 subjects (33%) ≤1 year-old and in 6 subjects (20%) that were >1 year old. Acute rejection of the transplant occurred in 6 subjects (20%) that were undernourished and in 5 subjects (35,7%) with good nutritional status. Analysis of the data found no relationship between age (p= 0,468; 95% CI 0,47-0,77; OR 1,917) and nutritional status (p=0,287; 95% CI 0,11-1,85; OR 0,450 to acute rejection in pediatric living donor liver transplant at RSCM. Observation in the first three months post-transplant reveal that mean levels of tacrolimus in the blood were 6-8 ng/mL on days 12-15, insufficient of reaching the target of obtaining an adequate immunosuppressive effect.

Conclusion: In this study, age and nutritional status of recipients during the time of transplant were found to be insignificant independent risk factors of liver transplant acute rejection. However, these two factors can be thought to effect recipients’ immune status, which plays a role in acute rejection post-transplant. The use of adequate immunosuppressant needs to be carefully monitored in suppressing rejection reactions post-liver transplant."

"Status gizi kurang di Indonesia masih merupakan masalah gizi utama yang belum tertanggulangi secara tuntas. Data Susenas 1999 menemukan 24,2% wanita usia subur menderita kurang energi kronis yang memberikan indikasi bahwa pada remaja putri masih terdapat gizi kurang khususnya kurang energi protein. Masalah kekurangan energi protein pada remaja khususnya remaja putri belum banyak mendapat perhatian. Dilain pihak remaja putri diharapkan dapat melahirkan generasi penerus yang sehat dan berkualitas. Penelitian ini bertujuan untuk memperoleh gambaran tentang status gizi remaja putri dan faktor-faktor yang berhubungan. Penelitian dilakukan pada Sekolah Menengah Umum Negeri dan Madrasah Aliyah Negeri di Kota Padang Propinsi Sumatera Barat. Disain penelitian ini adalah potong lintang (cross sectional), yang dilakukan pada bulan Februari - Maret 2002. Pengambilan sampel dilakukan secara systematic random sampling terhadap siswi dengan jumlah sampel 293 orang, yang sekaligus dijadikan sebagai responden. Pengumpulan data status gizi dengan cara pengukuran berat dan tinggi badan dan pengukuran variabel bebas seperti persepsi terhadap ukuran tubuh, aktifitas fisik, kebiasaan makan, pengetahuan gizi, riwayat penyakit dan penghasilan keluarga dengan wawancara terstruktur sedangkan konsumsi zat gizi (energi, protein, lemak dan karbohidrat) dengan "recall 24 jam". Status gizi ditentukan dengan Indeks Massa Tubuh dari hasil pengukuran berat dan tinggi badan. Analisis bivariat dilakukan dengan uji Kai-Kuadrat dan analisis multivariat dengan Regresi Logistik Ganda. Hasil penelitian ini mendapatkan proporsi responden yang mempunyai status gizi kurang sebesar 30.7% dengan penyebaran 23.9% dengan status kekurangan gizi tingkat ringan (IMT 17.0 -18.5) dan 6.8% kekurangan gizi tingkat berat (IMT 17.0). Sebagian besar responden mempunyai tingkat konsumsi zat gizi kurang (74.7% tingkat konsumsi energi kurang, 56.0% tingkat konsumsi protein kurang, 68.6% tingkat konsumsi lemak kurang dan 58.4% tingkat konsumsi karbohidrat kurang), sebanyak 49.5% responden mempunyai persepsi terhadap ukuran tubuh kurang, 51.2% mempunyai aktifitas fisik tinggi, 47.1% mempunyai kebiasan makan kurang, 41.3% mempunyai pengetahuan gizi kurang, 30.0% mempunyai riwayat penyakit dan 66.3% mempunyai penghasilan tinggi. Hasil penelitian menunjukkan ada hubungan yang bermakna tingkat konsumsi energi, persepsi terhadap ukuran tubuh dan aktifitas fisik dengan status gizi responden (p<0.05). Persepsi terhadap ukuran tubuh dan tingkat konsumsi energi merupakan faktor dominan yang berhubungan dengan status gizi responden. Dari hasil penelitian tersebut disarankan agar lebih dipererat kerjasama antara Dinas Pendidikan Nasional dan Dinas Kesehatan Propinsi Sumatera Barat, dalam hal penyebarluasan informasi gizi dan kesehatan kepada anak didik melalui kegiatan Usaha Kesehatan Sekolah serta melakukan monitoring status gizi anak didik secara berkala. Disamping itu juga disarankan untuk memasukkan mata ajaran tentang gizi dan kesehatan dasar secara khusus sebagai muatan lokal. Penelitian tentang masalah gizi remaja perlu diperbanyak agar didapatkan informasi yang lebih banyak pula tentang masalah gizi remaja yang dapat dipergunakan sebagai bahan pertimbangan dalam penyusunan program gizi pada remaja.

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Factors that Related to the Girl Adolescences Nutritional Status at a State Senior High School and State Islamic High School in Padang-West Sumatra Province in 2002Malnutrition in Indonesia still become a main problem in nutrient that haven't covered yet The National Social Economic Survey (1999) found that 24.2 % woman in a fertile age suffer from chronically energy malnutrition. This condition gives indication that adolescences have an undernourished especially protein energy malnutrition. Energy protein malnutrition problem in adolescences especially woman haven't get a lot of attention. In other side, they are expected to birth a quality and healthy generation.

The objective of this research was to obtain illustration about adolescences nutritional status and factors that related to it. This research was conducted in state senior high school and state Islamic senior high school in Padang-West Sumatra Province. The research design was cross sectional that done in February-March 2002. The sample taking done by using a systematic random sampling to girl students and the entire sample were 293 persons that then become a respondent.

Dependent variables of data collecting such as body size perception, physical activity, eating habit, nutrient knowledge, disease background, and family income collected by using a structural questionnaire while nutritional consumption (energy, protein, fat and carbohydrate) using a 24 hours recall. And the nutritional status determined by using calculation Body Mass Index (BMI) was taken from height and weight of each respondent. Bivariat analysis used a Chi-Square Test, and the multivariat analysis use a Multiple Logistic Regression.

The Result of the research showed that 30.7 % respondent were malnutrition with spread of 23.9% respondent were mild malnutrition (BMI 17.0-18.5) and 6.8% were severe malnutrition (BMI < 17.0) almost all respondent get an low nutritional level consumption (74.7% low energy consumption, 56.0% low protein consumption, 68.6% low fat consumption and 58.4% low carbohydrate consumption), 9.5% respondent have a low body size perception, 51.2% had high physical activity, 47.1% had low eating habit, 41.3% had low nutritional knowledge, 30.0% had a disease background and 66.3% have a high income.

The result showed that there is a significant relation between energy consumption, body size perception, and physical activity with a respondent nutrient status (p<0.05). Body size perception and energy consumption is the dominant factor that related to the respondent nutritional status.

According to the result, it suggested that the National Education Department and Health Department of West Sumatra Province should make a strong partnership in the way to spread out nutrient and health information to students through School Health Attempt and make a monitoring of students nutrient status periodically. Beside that, it also suggests to put a basic nutrient and health as a subject matter in school. We need a lot of research concern in adolescences problems in order to get more information about adolescences nutrient problems that can be considered in making a nutrient program for adolescences."

"Status gizi kurang yang dialami pasien selama rawat inap di rumah sakit akan berdampak pada rendahnya penyembuhan pasien dari penyakit yang diderita dan berujung pada hari rawat yang lebih lama, angka kesakitan dan biaya rawat meningkat. Kejadian gizi kurang pasien penyakit dalam masih cukup tinggi, penelitian di Universitas Alabama 46% pasien menderita kurang gizi dan di RSCM berkisar 34.2-51.4% mengalami hal yang sama.Penilitian ini merupakan penelitian primer yang dilakukan di ruang rawat Penyakit Dalam kelas III Rumah Sakit Dr. Cipto Mangunkusumo, dengan tujuan untuk mengetahui hubungan antara asupan makan dengan status gizi pasien rawat inap penyakit dalam RSCM. Dilaksanakan pada bulan April hingga Awal Juni 2006. Responden adalah pasien rawat inap penyakit dalam usia 18-60 tahun yang memenuhi kriteria inklusi dan eksklusi. Desain penelitian dengan analitik potong lintang, terpilih 91 sampel laki-laki dan perempuan secara purposive. Pengolahan dan analisis data menggunakan program FP2 dan SPSS.Penilaian asupan makan yang diterjemahkan kedalam energi dan protein dinilai dengan food recall 2x24 jam. Adapun penilaian status gizi dengan melakukan pengukuran antropometri, albumin serum dan pemeriksaan SGA (subjective global assessment). Penilaian selera makan dengan wawancara, jenis penyakit dan obat didapat dari rekarn medis.Hasil penelitian menunjukkan bahwa sebanyak 47 responden (51.6%) asupan makan kurang dari kebutuhan dan sebanyak 44 responden (48.4%) asupan makan cukup. Penilaian status gizi dengan 3 pengukuran yaitu antropometri (IMT), SGA dan albumin serum ditemukan status gizi kurang masing-masing 45.1%, 53.8%, dan 61.5%.Dengan uji kai kuadrat didapatkan adanya hubungan yang bermakna antara asupan makan dengan status gizi kecuali dengan parameter albumin serum. Analisis multivariat regresi logistik didapatkan hasil, responden dengan asupan makan kurang berisiko mengalami status gizi kurang 3.143 kali dibandingkan responden dengan asupan makan eukup setelah dikontrol variabel jenis kelamin dan selera makan.Didapatkan hubungan yang bermakna antara selera makan dengan status gizi. Data yang didapat tidak dapat membuktikan adanya hubungan antara penyakit, obat, jenis kelamin, dan usia terhadap status gizi.Bertitik tolak dari hasil penelitian yang diperoleh disarankan kepada manajemen rumah sakit untuk mengadakan standar makanan tinggi kalori tinggi protein dan perlu adanya dukungan gizi (nutritional support) bagi pasien rawat inap penyakit dalam, dalam bentuk makanan enteral maupun lainnya. Menyertakan diagnosis status gizi pasien berdasar SGA kedalam diagnosis penyakit. Bagi unit penyelenggara makanan rumah sakit untuk meningkatkan cita rasa masakan.

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Undernourished status of in-patient in hospital will have an impact on the low rate of recovery from the disease one suffers and end up with longer stay in hospital, increase in morbidity and cost. Incidence of undernourished among in-patient of internal medicine ward is high. Study by University of Alabama 46% of patient suffer from undernourished and in RSCM is around 34.2 - 51.4%.

This study is primarily study conducted in Internal Medicine Ward CIass III, RSCM. The aim of the study was to know the relationship between food intake and nutritional status of in-patient of internal medicine ward, RSCM. The study was conducted from April to early June 2006. Respondent was patient of in-patient internal medicine ward aged 18-60 years with certain inclusive and exclusive criteria. The study design was analytic cross-sectional with 91 male and female respondent selected purposively. Data processing and analysis was using FP2 and SPSS.

Calculation of food intake that translated into energy and protein was from food recall 2x24 hours method. Nutritional status was based on anthropometric measurement, albumin serum and examination of Subjective Global Assessment (SGA). Examination of appetite was by interview, type of disease and medicine were noted from medical record.

The results show that 47 respondent (51.6%) had food intake less than daily requirement. Nutritional status using 3 (three) assessments i.e. anthropometric which is Body Mass Index (BMI), SGA and albumin serum was found that 45.1%, 53.8%, and 61.5% respectively under normal.

Statistical test (chi-square) showed a significant relationship between food intake and nutritional status except with albumin serum. Multivariate analysis showed that patient with food intake less than daily requirement had 3.143 times risk of undernourished after controlling sex and appetite.

There was a relationship between appetite and nutritional status. However, there was no relationship between disease, medicine, sex and age with nutritional status.

From these findings it is recommended that hospital management to take some measures on food standard for high calorie and high protein and need nutritional support for in-patient of internal medicine ward in the form of enteral food or others. Additional diagnosis of nutritional status using SGA was needed in the disease diagnosis. For hospital food management unit it is recommended to increase food taste."

"Kekurangan gizi yang terjadi pada masa dalam kandungan hingga usia 2 tahun dapat mengakibatkan terganggunya perkembangan otak, mental dan kemampuan motorik bahkan dapat mengakibatkan cacat permanen kanena 80% tumbuh kembang otak tetjadi pada masa ini. Detisit otak akan sulit terkejar karena masa cepat tumbuh hanya berlangsung sampai usia 18 bulan. Penclitian ini bertujuan untuk mengetahui faktor yang berpengaruh dan memprediksi faktor yang paling berperan terhadap status gizi anak baduta di Propinsi Jawa Barat. Penelitian ini merupakan analisis data sekunder “NSS IIKI” putaran 20 dan 22, menggunakan rancangan repezted cross sectional. Populasi dari penelitian ini adalah anak balita (0-23 bulan) di wilayah pcdesaan Jawa Barat. Sampel yang memenuhi kriteria inklusi dan eksklusi pada putaran kc 20 adalah 2232 orang dan putaran 22 adalah 2093 orang. Analisis data meliputi analisis univariabel, bivariabel (regresi Iogistik multinomial sederhana) dan multivariabel (regresi logistik multinomial ganda). Hasil penelitian menunjukkan terdapat masalah kesehatan masyarakat di Jawa Barat, baik pada musim kemarau maupun musim hujau. Hasil analisis bivariabel pada musim kemarau didapatkan hubungan yang bermakna antara variabcl pcndidikan ibu, status ketja ayah. pengeluaran perkapita dan penyakit infeksi dengan status gizi anak baduta. Sedangkan di musim hujan didapatkan hubungan yang bermakna antara variabel pendidikan ibu dan penyakit infeksi. Dari analisis multivariabcl pada musim kemarau didapatkan hubungan yang bermakna antara pendidikam ibu, status kgrja ayah, pengeluaran perkapita dan penyakit infeksi dengan status gizi baduta. Sedangkan pada musim hujan, didapatkan hubungan yang bcrmakna pada variabel pcndidikan ibu dan penyakit infeksi dengan status gizi. Faktor yang paling dominan pengaruhnya terhadap status gizi anak baduta di musim kemarau adalah adalah status pengeluaran perkapita. Faktor yang paling dominan di musim hujan adalah pendidikan ibu. Disarankan kepada penanggung jawab program untuk memberikan prioritas penanggulangan masalah gizi pada anak balita. Untuk mengatasi masalah pcrekonomian kelunrga perlu diupayakan suatu cara untuk menambah pcnghasilan keluarga. Perlu diberikan penyuluhan kepada ibu tentang penyakit-penyakit yang dapat diderita oleh anak.

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Malnutrition of children under two years old may have a major effect on brain development and can result in permanent mental retardation and motoric ability, because 80% of brain development occurs in this period. Reduced brain growth is irreversible because brain development taking place until 18 months old.

The objectives of this research were to study affecting factors and to predict the rolling factors on nutritional status of under two years children in West Java Province. The ‘NSS HKI” secondary data used in this research were round of 20th and 22nd by repeated cross sectional design. The population of this research was children under two years old in West Java mral area. Based on inclusion and exclusion criteria, it was definite 2232 samples of the 20"‘ round and 2093 samples of the 22“d round. Data were examined by univariate, bivariate and multivariate (multinomial logistic regression) analysis.

The results showed that there was community health problem in West Java both on wet and dry seasons. Bivariate analysis on dry season demonstrated significant correlation among length of schooling for mother, father’s occupation, expenditure per capita and infection diseases with nutritional status of under two years old children. While in wet season, there was significant correlation among length of schooling for mother and infection diseases with nutritional status of under two years children. Expenditure per capita was found as a dominant factor in dry season. Length of schooling for mother was found as a dominant factor in wet season.

It was suggested that program coordinator commit highly priority on resolving malnutrition problem of under two years old children. Improvement of economical status based on local resources must be the important program of the government. Recognizing of the crucial diseases for the children has to be educated to the parents, especially mother."

"This third volume of the Springer series discussing pediatric cancer focuses on diagnosing, treating, and assessing the future course of malignant brain neoplasms in children. In addition to a general introduction to the principals involved, the material includes vital research in molecular genetics, a major contribution to the molecular characterization of solid tumors, which will define new biomarkers of the disease and identify molecular pathways. The volume includes presentations of present and future therapies. The volume also explains AT/RT’s dissemination to the cerebral fluid, the molecular mechanisms underlying the progression of medulloblastoma, and the importance of gamma knife radiosurgery during multimodality management of medulloblastoma/PNET tumors. Other topics discussed include using magnetic resonance imaging for diagnosing retinoblastoma, and mapping the effects of radiotherapy in low-grade glioma in children. Information on alterations in cell-cycle regulators that are influenced by tumor suppressor genes and oncogenes is detailed. Contributors provide recommendations concerning non-narcotic analgesic routines for children recovering from cranial and spinal surgery. "

"Tumor otak sekunder dapat menyebabkan masalah nutrisi. Manifestasi klinis penurunan selera makan, gangguan menelan, mual, muntah, hemiparesis, kejang, gangguan fungsional dan kognitif dapat menurunkan asupan makanan dan berat badan sehingga berisiko malnutrisi. Perubahan metabolisme makronutrien dan mikronutrien yang terjadi juga memengaruhi terjadinya malnutrisi. Tatalaksana terapi medik gizi yang diberikan bertujuan mempertahankan atau memperbaiki status gizi sehingga meningkatkan kualitas hidup dan memperlama harapan hidupnya. Terapi medik gizi yang sesuai rekomendasi European Society of Clinical Nutrition and Metabolism (ESPEN) adalah diet seimbang yang meliputi makronutrien, mikronutrien, nutrien spesifik, dan edukasi. Pasien serial kasus ini adalah perempuan, berusia antara 48 sampai 59 tahun dengan diagnosis tumor otak sekunder. Tiga pasien memiliki tumor primer kanker payudara, sedangkan satu pasien dengan kanker endometrium. Skrining menggunakan malnutrition screening tool (MST) dilanjutkan asesmen gizi. Terapi medik gizi diberikan sesuai rekomendasi ESPEN dan toleransi pasien. Pemantauan gizi meliputi pemeriksaan fisik, antropometri, komposisi tubuh, kapasitas fungsional dan analisis asupan. Hasil menunjukkan semua pasien mencapai asupan makan sesuai target pemberian makronutrien, mikronutrien, dan nutrien spesifik. Status gizi berhasil dipertahankan dengan tiga pasien mengalami peningkatan BB. Kapasitas fungsional keempat pasien menunjukkan perbaikan dengan menggunakan Karnofski dan Eastern Cooperative Oncology Group (ECOG). Pemeriksaan handgrip hanya dapat dilakukan pada 3 pasien menunjukkan perbaikan.

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A secondary brain tumor may cause nutritional problems. Clinical manifestations such as decreased appetite, swallowing disorders, nausea, vomiting, hemiparesis, seizures, functional and cognitive disorders may reduce food intake and increase malnutrition. Also changes in metabolism can affect the malnutrition. The aim of the medical nutrition therapy to maintain nutritional status to improve the quality of life and life expectancy. Balance diet were recommended by European Society of Clinical Nutrition and Metabolism (ESPEN) includes macronutrients, micronutrients, specific nutrients with continuing nutrition education. Patients are females, aged 48 to 59 years, with secondary brain tumor. The primary tumor of three patients were breast cancer and one patient was endometrial cancer. Screening was done using the malnutrition screening tool (MST) and followed with nutritional assessment. Medical nutrition therapy were given based on ESPEN recommendations and patient tolerance. Nutrition monitoring includes physical examination, anthropometry, body composition, functional capacity and intake analysis. Patient’s monitoring showed that all patients achieved their intake targets. The body weight of three patient increased showed that the nutrition status was maintained well enough. Patient’s functional capacity were improved according to Karnofsky and Eastern Cooperative Oncology Group (ECOG). Handgrip examination were also improve when it was assesed on three patients."