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"ABSTRAKLatar belakang: Anak HIV yang hidup di daerah endemis campak harus memiliki antibodi campak yang protektif karena mereka memiliki risiko lebih tinggi untuk terinfeksi dan mendapatkan komplikasinya. Belum ada laporan mengenai seroprevalens antibodi campak pada anak HIV di Jakarta. Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui seroprevalens antibodi campak dan faktor-faktor yang berhubungan dengannya pada anak-anak HIV.Metode: Penelitian ini merupakan studi potong lintang yang dilakukan di poliklinik Alergi-Imunologi RSCM pada Desember 2019 hingga Februari 2020. Kriteria inklusiadalah anak usia 1-18 tahun yang telah didiagnosis terinfeksi HIV dan bersedia ikut dalam penelitian. Sampel darah diperiksa untuk mengetahui nilai IgG anti campak.Seroprotektif jika nilai IgG anti campak ≥330 IU/l. Data dikumpulkan dan dianalisis dengan menggunakan uji regresi logistik. Hasil: Dari 74 subjek, didapatkan laki-laki 44 orang (59,5%), 64,9% anak didiagnosis terinfeksi HIV dan mendapatkan terapi ART pada usia 12 sampai 60 bulan, 73% anak mendapatkan vaksin campak pertama mereka pada usia kurang dari 12 bulan, 52,7% mendapat vaksin campak yang terakhir pada usia sekolah, dan 55,4% mendapatkan vaksinasi campak sebanyak dua kali atau lebih. Sebagian besar pasien tanpa imunodefisiensi (86,5%), dan 50% subjek memiliki status seroprotektif antibodi campak. Tidak ada hubungan bermakna antara status seroprotektif antibodi campak dengan usia, usia vaksinasi campak pertama, frekuensi vaksinasi campak, dan status imunodefisiensi.Simpulan: Sebesar 50% anak HIV memiliki antibodi campak protektif. Status seroprotektif ini tidak memiliki hubungan bermakna dengan usia, usia vaksinasi campakpertama, frekuensi vaksinasi campak, dan status imunodefisiensi.

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Background: HIV children living in endemic measles areas must have protective measles antibodies because they have a higher risk to be infected and get complications. There are no reports of measles antibody seroprevalence in HIV children in Jakarta. Aim: The aim of this study was to determine the seroprevalens of measles antibodiesand its related factors in HIV children. Methods: This is a cross-sectional study conducted at the RSCM Allergy-Immunology Clinic from December 2019 to February 2020. Inclusion criteria were children aged 1- 18 years who had been diagnosed with HIV and were willing to participate in this study. Blood samples were examined to determine the value of anti-measles IgG. Seroprotective if IgG anti-measles titre ≥330 IU/l. Data is collected and analyzed using logistic regression test. Results: Of 74 samples, there were 44 men (59.5%), 64.9% of children were diagnosedwith HIV and received ART at 12 to 60 months, 73% of children received their first measles vaccine before 12 months of age, 52.7% got their last measles vaccine at school age, and 55.4% got measles vaccinations twice or more. The majority of patients without immunodeficiency (86.5%), and 50% of the sample had seroprotective statusfor measles antibodies. There was no significant relationship between seroprotective status of measles antibody with age, age of first measles vaccination, frequency of measles vaccination, and immunodeficient status. Conclusion: As 50% HIV children have seroprotective measles antibody. There is no significant relationship between seroprotective status and age, age at first meaasles vaccination, number of measles vaccination, and immunodeficiency status."

"Latar belakang: Diare merupakan masalah kesehatan paling sering pada anak.Berbagai penyebab diare dapat menyebabkan diare berlangsung lama dan bisa menjadi malnutrisi (gizi buruk).Penyebab diare bisa disebabkan oleh infeksi bakteri dan membutuhkan antibiotik sehingga diperlukan deteksi sedini mungkin. Pemeriksaan soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) dapat menduga adanya infeksi bakteri pada anak dengan diare akut. Tujuan :Mengetahui seberapa besar nilai diagnostik peningkatan leukosit dalam tinja dibandingkan dengan sTREM-1. Metode :studi potong lintang terhadap anak usia 6-60 bulan dengan diare akut tanpa komplikasi dan penyerta penyakit lain. Pada subyek dilakukan anamnesis gambaran klinis (demam, muntah, sakit perut), pemeriksaan leukosit dalam tinja dan pemeriksaan sTREM-1 sebagai referensi standard. Hasil : Anak dengan diare akut oleh karena infeksi bakteri usia 6-60 bulan dengan sTREM-1>470 pg/mL sebanyak 2 dari 64 subyek penelitian dan leukosit tinja > 10 / LPB sebanyak 14 dari 64 subyek penelitian, terbanyak lelaki, status nutrisi normal dan memiliki gambaran klinis demam, muntah dan tanpa sakit perut. Peningkatan leukosit tinja > 10 / LPB memiliki sensitifitas 50 %, spesifisitas 79,1 %, nilai prediksi positif 7,1 %, nilai prediksi negatif 98 %, akurasi 78 %, nilai rasio likelihood positif 2,18 dan nilai rasio likelihood negatif 0,63. Simpulan :Peningkatan leukosit tinja > 10 / LPB sebagai konfirmasi diagnostik kurangbaik dalam mendiagnosis diare akut oleh karena infeksi bakteri.

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Background: Diarrhea is a health problem most often occurs in children. Various etiology of diarrhea can cause prolonged diarrhea and become malnourished (malnutrition). The etiology of diarrhea can be caused by a bacterial infection and requires antibiotics, so that detection is needed as early as possible. Examination of soluble triggering expressed receptors on myeloid cells-1 (sTREM-1) can predict bacterial infection in children with acute diarrhea. Objective: toknow how much the diagnostic value of fecal leukocytes test compared to sTREM-1. Methods: cross-sectional study of children aged 6-60 months with acute diarrhea without complications and other diseases. In the subjects, clinical manifestation was performed (fever, vomiting, abdominal pain), fecal leukocyte test and sTREM-1 test as a standard reference. Results : Children, aged 6-60 months with acute diarrhea due to bacterial infections

with sTREM-1> 470 pg / mL as many as 2 of 64 subjects and fecal leukocytes > 10 / HPF as many as 14 of 64 subjects, most male, normal nutritional status and had clinical

manifestation of fever, vomiting and without abdominal pain. Increased fecal leukocytes > 10 / HPF has a sensitivity of 50%, specificity 79.1%, positive predictive value 7.1%, negative predictive value 98%, accuracy 78%, positive likelihood ratio 2.18 and negative likelihood ratio 0, 63. Conclusion: Fecal leukocyte test > 10 / HPF as a diagnostic confirmation is not good in

diagnosing acute diarrhea due to bacterial infection."

"Latar Belakang : Penggunaan narkotika, psikotropika dan zat adiktif lainnya (NAPZA) pada usia remaja menjadi salah satu masalah sosial besar yang kita hadapi dalam masyarakat dan memberikan dampak negatif. Tujuan: Mengetahui karakteristik dan faktor yang memengaruhi perilaku berisiko tinggi penggunaan NAPZA pada remaja sekolah menengah, serta memperkenalkan kuesioner CRAFFT sebagai instrumen penyaring awal terhadap penggunaan narkoba dan alkohol. Metode: Studi kuantitatif (kuesioner yang divalidasi) terhadap 514 subjek usia 12-18 tahun yang dipilih secara konsekutif. Kuesioner CRAFFT digunakan untuk mendeteksi perilaku berisiko tinggi penggunaan narkotika, psikotropika dan alkohol. Faktor-faktor risiko diperoleh melalui kuesioner yang diisi secara mandiri oleh responden. Analisis statistik menggunakan analisis bivariat (uji kai kuadrat atau uji Fischer) dan multivariat (uji regresi logistik). Hasil: Sebesar 19,6% subjek terlibat dalam perilaku berisiko tinggi penggunaan NAPZA dan sebagian besar adalah laki-laki 12,4%. Perilaku berisiko tinggi penggunaan NAPZA, terdiri dari perilaku merokok (23,8%), minum minuman beralkohol (15,8%), dan penggunaan obat-obatan terlarang dan zat adiktif lainnya (13,6%). Sebagian besar subjek (18,9%) mencoba rokok pertama kali saat usia remaja awal (10-13 tahun), sedangkan minum minuman beralkohol (12,6%) dan menggunakan obat terlarang dan zat adiktif lainnya (9,1%) dimulai saat remaja menengah menengah (14-16 tahun). Jenis obat terlarang yang digunakan, antara lain ganja (52,7%), tramadol (15,2%), dekstrometorfan (10,7%), dan shabu-shabu (6,3%). Kuesioner CRAFFT memiliki reliabilitas yang baik dengan Cronbach’s α sebesar 0,73. Tingkat pendidikan (RO 9,56; p= 0,000), pola asuh otoriter (RO 27,25; p= 0,000), orangtua tidak harmonis (RO 4,00; p= 0,001), tekanan atau ancaman teman sebaya (RO 3,26; p= 0,006), dan kegiatan ekstrakurikuler (RO 2,04; p= 0,048) merupakan faktor yang memengaruhi perilaku risiko tinggi penggunaan alkohol dan narkoba pada remaja. Simpulan: Remaja memiliki risiko besar terlibat dalam perilaku berisiko tinggi penggunaan NAPZA, sehingga dibutuhkan deteksi dini, penanganan yang komprehensif yang melibatkan multidisiplin, serta intervensi terhadap faktor risiko yang ada. CRAFFT dapat digunakan sebagai salah satu instrumen penyaring terhadap penggunaan penggunaan narkotika, psikotropika, dan alkohol pada remaja.

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Background: Narcotics, psychotrophics and addictive substances (NPA) used in adolescents becomes one of the major social problems we are facing in society and gives a negative impact.

Objective: To determine the characteristics and factors that influence high risk behavior of NPA used in adolescents in middle and high school, also introducing CRAFFT questionnaire as an early screening tool for alcohol and illicit drugs use.

Method: Quantitative study (validated questionnaire) was conducted among 514 subject aged 12-18 years old using a consecutive sampling. CRAFFT questionnaire was used to detect a high risk behavior of alcohol and illicit drugs use and self-reported questionnaire used to determine the risk factors of NPA. Statistical analysis was done using bivariate (Chi-square or Fischer tests) and multivariate (logistic regression) analysis.

Results: Most participants (19,6%) were involved in high risk behavior of alcohol and illicit drugs, with the majority of males (12,4%). The high risk behavior, consisted of smoking (23,8%), drinking alcohol (15,8%) and illicit drugs use (13,6%). Majority of the participants (18,9%) started to smoke in early adolescence (10-13 years old), while drinking alcohol (12,6%) and illicit drugs use (9,1%) started in mid adolescence (14-16 tahun). The type of drugs being used were cannabis (52,7%), tramadol (15,2%), dextromethorphan (10,7%) and methamphetamine (6,3%). CRAFFT questionnaire has a good internal consistency with Cronbach’s α 0,73. Education level (OR 9,56; p= 0,000), authoritarian parenting style (OR 27,25; p= 0,000), parents not harmonious (OR 4,00; p= 0,001), peer pressure or threat (OR 3,26; p= 0,006) and extracurricular activities (OR 2,04; p= 0,048) were factors that influenced high risk behavior of alcohol and illicit drugs use in adolescents.

Conclusion: Adolescents have a high risk behavior of alcohol and illicit drugs usage, therefore, early detection, comprehensive treatment involving multidisciplinary and intervention of risk factors are needed. CRAFFT can be used as one of the screening tools for detecting alcohol and illicit drugs use in adolescents."

"Latar belakang: Penyakit refluks gastroesofagus (PRGE) adalah kejadian refluks gastroesofagus yang telah disertai gangguan kualitas hidup atau komplikasi. Angka kejadian PRGE di seluruh dunia sangat beragam dan dipengaruhi oleh distribusi usia. Penyakit gastrointestinal fungsional melatar belakangi terjadinya PRGE. Angka kejadian PRGE pada usia 10—12 tahun yang merupakan masa awal remaja serta hubungan PRGE dengan kejadian gastrointestinal di Indonesia belum pernah dilaporkan.Metode: Studi potong lintang yang dilanjutkan dengan studi kasus kontrol dilakukan terhadap seluruh siswa kelas 4—6 SD, SDN Kenari 1—12, Jakarta pada bulan Mei—Juli 2014. Penegakkan diagnosis PRGE menggunakan kuesioner frequency scale for the symptoms of gastroesofageal reflux disorder (FSSG) dengan melalui translasi kuesioner. Kolik infantil dan gumoh ditegakkan sesuai kriteria ROME III. Sakit perut berulang ditegakkan sesuai kriteria Apley.Hasil penelitian: Validasi kuesioner hasil translasi ke bahasa Indonesia menunjukkan validitas (seluruh pertanyaan memiliki r > 0,3 dengan p < 0,05) dan reabilitas (Cronbach alpha 0,853 dengan item reability index setiap pertanyaan > 0,3) yang baik. Angka kejadian PRGE 404 (44,6%) dari 905 orang anak usia 10—12 tahun dengan interval kepercayaan 95% (IK 95%) 41,4% sampai 47,9%. Odd ratio PRGE pada lelaki dibandingkan perempuan 0,841 (IK 95% 0,646 sampai 1,095; p = 0,198). Kejadian kolik infantil, gumoh, dan sakit perut berulang berturut-turut 23,3%, 16,9%, dan 3%. Tidak ditemukan hubungan bermakna antara jenis kelamin (p = 0,299), kelompok usia (p = 0,902), kolik (p = 0,226), dan sakit perut berulang (p = 0,353) dengan kejadian PRGE. Hasil analisis multivariat menunjukkan gumoh dan riwayat orang tua dengan PRGE berhubungan dengan kejadian PRGE pada anak usia 10—12 tahun dengan odd ratio berturut-turut 2,166 (IK 95% 1,226 sampai 3,827) dan 3,069 (IK 95% 1,233 sampai 7,637).Simpulan: Angka kejadian PRGE pada anak usia 10—12 tahun di Indonesia adalah 44,6%. Regurgitasi pada masa bayi dan riwayat PRGE pada orang tua berhubungan dengan kejadian PRGE pada anak usia 10—12 tahun. Tidak ditemukan hubungan bermakna antara kolik infantil dan riwayat sakit perut berulang terhadap kejadian PRGE.

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Introduction: Gastroesophageal reflux disease (GERD) is an event of gastroesophageal reflux followed by certain disruption in quality of life or one of which cause some complications. Prevalence of GERD varies greatly worldwide and influenced by age distribution. Functional gastrointestinal disorders are responsible for GERD. GERD prevalence in children aged 10—12 years old, which is an early adolescence phase, as well as correlation between GERD and other gastrointestinal disorder were never been reported in Indonesia.

Method: A cross sectional study followed by a case control study were done to all elementary students grade 4—6 who studied in SDN Kenari 1—12, from May to July 2014. Diagnosis of GERD was established using frequency scale for symptoms of gastroesophageal reflux disorder (FSSG), which was translated into Indonesian language. Infantile colic and regurgitation were diagnosed according to ROME III criteria while recurrent abdominal pain according to Apley criteria.

Result: Validation of the translated FSSG questionnaire showed that it was valid (all question had r > 0.3 with p < 0.05) and reliable (Cronbach alpha 0.853 with item reliability index on each question > 0.3). Prevalence of GERD was 404 (44.6%) out of 905 children aged 10—12 years old wih confidence interval of 95% (95% CI, 41.4% to 47.9%). Odd ratio (OR) of GERD in males compared to females was 0.841 (95% CI, 0.646 to 1.095; p = 0.198). Prevalence of infantile colic, regurgitation, and reccurent abdominal pain were 23.3%, 16.9%, and 3% respectively. There were no significant correlation in GERD prevalence with sex (p = 0.299), age group (p = 0.902), infantile colic (p = 0.226), and recurrent abdominal pain (p = 0.353). Multivariate analysis showed that GERD prevalence correlated with regurgitation (OR 2.166; 95% CI, 1.226 to 3.827) and parental history of GERD (OR 3.069; 95% CI, 1.233 to 7.637).

Conclusion: GERD prevalence in children aged 10—12 years old in Indonesia was 44.6%. Infant regurgitation and parental history of GERD correlated with the event of GERD in children aged 10—12 years old. There is no significant correlation between infantile colic and history of reccurent abdominal pain with GERD prevalence."

"[Latar Belakang. Bayi kurang bulan (BKB) memiliki risiko tinggi mengalami gangguan neurobehavioral. Gangguan tersebut dapat dipengaruhi oleh faktor prenatal, natal, dan perinatal. Perlu dilakukan deteksi dini gangguan agar dapat dilakukan intervensi dini. Penilaian neurobehavioral metode Dubowitz dapat digunakan untuk deteksi dini gangguan neurobehavioral pada BKB.Tujuan. Mengetahui proporsi dan faktor risiko yang berhubungan dengan gangguan neurobehavioral BKB. Mengetahui hubungan antara kelompok bayi risiko tinggi dengan kejadian gangguan neurobehavioral.Disain Penelitian. Penelitian ini merupakan penelitian dengan studi potong lintang analitik untuk mengetahui karakteristik penilaian neurobehavioral BKB dengan metode Dubowitz dan faktor risiko yang berhubungan. Subjek penelitian adalah BKB yang pernah dirawat di Divisi Perinatologi Rumah Sakit Cipto Mangunkusumo (RSCM). Dilakukan analisis bivariat dengan uji kai kuadarat dan dilanjutkan dengan analisis multivariat dengan uji regresi logistik.Hasil Penelitian. Didapatkan 106 subjek yang sesuai dengan kriteria inklusi dan eksklusi. Proporsi BKB yang mendapat nilai suboptimal pada pemeriksaan neurobehavioral metode Dubowitz adalah 57,5%. Faktor risiko yang berhubungan dengan gangguan neurobehavioral adalah sepsis (OR 6,23 (IK 95% 2,18-17,73); p=0,001), perdarahan intraventrikular (OR 6,23 (IK 95% 2,18-17,73) p=0,007); dan berat lahir ≤1500 gram (OR 3,46 (IK 95% 1,15-10,37), p=0,027). Didapatkan 37 subjek (34,9%) masuk ke dalam kelompok risiko tinggi dan 69 subjek (65,1%) risiko rendah. Terdapat 86,5% bayi di kelompok risiko tinggi mendapatkan penilaian neurobehavioral suboptimal. Terdapat hubungan yang bermakna antara kelompok bayi risiko tinggi dengan penilaian suboptimal metode Dubowitz, dengan p<0,001.Simpulan. Faktor risiko yang berhubungan dengan penilaian suboptimal pada pemeriksaan neurobehavioral adalah sepsis, perdarahan intraventrikular, dan berat lahir ≤1500 gram. Bayi kelompok risiko tinggi berhubungan dengan besarnya penilaian suboptimal pada pemeriksaan neurobehavioral metode Dubowitz., Background. Preterm baby tend to be at risk for having neurobehavioral impairment. The risk factors included prenatal, natal, and perinatal factors. Early recognition of infants at risk for development disability is important. The Dubowitz Neurological Assessment can be used to evaluate infants at risk for developmental disabilitiesis.Objective. To determine proportion and factors that related to Dubowitz Neurobehavioral assesment in preterm baby.Methods. Cross-sectional study involving preterm baby in Cipto Mangunkusumo Hospital. The Dubowitz Neurobehavioral Assesment was performed to asses the neurobehavioral pattern at 37-40 weeks post menstrual age. The risk factors data was collected retrospectively from the medical record. Statistical analysis was done using bivariate (Chi-square test) and multivariate analysis (logistic regression) analysis.Results. One hundred and six infants fullfilled the eligibility criteria. Based on The Dubowitz Neurological Assesment, 57,5% subjects got suboptimal score. Logistic regression analysis showed significant association between sepsis (OR 6,23 (IK 95% 2,18-17,73); p=0,001), intraventricular haemorrhage (OR 6,23 (IK 95% 2,18-17,73) p=0,007); and birth weight ≤1500 gram (OR 3,46 (IK 95% 1,15-10,37), p=0,027) and neurobehavioral impairment. There was 86,5% from all high risk babies that got suboptimal score with signifficant association, p<0,001.Conclusion. In preterm infants, sepsis, intraventricular haemorrhage, and low birth weight can become factors that related to the neurobehavioral impairment. High risk babies potential to have neurobehavioral impairment.]"

"Latar belakang. Hiperplasia adrenal kongenital (HAK) adalah suatu kelainan genetik yang bersifat autosomal resesif. Lebih dari 90% kasus terjadi akibat defisiensi enzim 21-hidroksilase (21-OHD) yang disebabkan oleh mutasi gen CYP21.Tujuan. Mengetahui profil mutasi CYP21 terhadap profil klinis anak dengan HAK di Indonesia.Metode. Studi deskriptif retrospektif dilakukan selama Oktober-Desember 2014. Subjek adalah anak HAK yang terdaftar di Klinik Endokrinologi Anak RSCM dan pernah dilakukan pemeriksaan mutasi gen CYP21. Data diambil dari anamnesis terhadap orangtua, rekam medis dan register HAK tahun 2009-2014.Hasil penelitian. Didapatkan total subjek sebesar 45 subjek (37 perempuan, 8 lelaki) dengan profil klinis tipe salt wasting (SW) 33 subjek, simple virilizing (SV) 10 subjek, dan non-classic (NC) 2 subjek. Median usia saat terdiagnosis pada tipe SW usia 1 bulan (0-3 bulan), tipe SV usia 3 tahun (2-6 tahun), tipe NC usia 5 tahun. Keluhan utama terbanyak adalah genitalia ambigus (60%). Subjek perempuan mengalami kesalahan penentuan jenis kelamin saat lahir (32,4%) dan memiliki perilaku maskulin (24,3%). Tiga jenis mutasi ditemukan pada dua subjek, dua jenis mutasi ditemukan pada 19 subjek, mutasi R356W saja dialami oleh 9 pasien, dan mutasi I172N saja ditemukan pada 15 pasien. Mutasi I172N ditemukan pada 80% alel, R356W pada 66,7% alel, dan delesi/LGC pada 4,4% alel. Tipe SW yang mengalami mutasi delesi/LGC dan atau R356W sebesar 63,6%.Simpulan. Manifestasi klinis terbanyak pada penelitian ini adalah tipe SW dengan mutasi R356W dan atau delesi/LGC. Pemeriksaan mutasi gen CYP21 bermanfaat untuk konseling genetik, diagnosis prenatal dan tata laksana pada keluarga yang memiliki risiko HAK.

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Background. Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disorder. More than 90% of cases are due to 21-hydroxylase deficiency which caused by CYP21 mutation.

Objective. Study the characteristic of CYP21 mutation and clinical manifestation in children with CAH in Indonesia.

Method. A descriptive retrospective study was performed during October-December 2014. Subjects were CAH children who were admitted to Pediatric Endocrinology Cipto Mangunkusumo hospital and tested for CYP21 gene mutation. Data were taken based on parents? interview, medical records and CAH registry during 2009-2014.

Results. A total of 45 subjects (37 girls, 8 boys) participated, with clinical profile of salt wasting (SW) type found in 33 subjects, simple virilizing (SV) in 10 subjects, and non-classical (NC) type in two subjects. Median age of diagnosis in SW type is 1 month old (0-3 month), SV type is 3 years old (2-6 years), NC type is 5 years old. Ambigous genitalia was the major chief complaint (60%). Girls experienced gender reassessment (32,4%) and show masculine behavior (24,3%). Three types of mutations were found in two patients, two types of mutations (R356W and I172N) in 19 patients, only R356W mutation in 9 patients, and only I172N mutation in 15 patients. I172N mutation was found in 80% alleles, followed by R356W in 66,7% alleles, and deletion/LGC in 4,4% alleles. In the SW form, 63,6% subjects had deletion and/or R356W mutation.

Conclusion. The most common clinical manifestation in this study is SW type with deletion/LGC and or R356W mutation. CYP21 mutation analysis may provide important information for genetic counseling, prenatal diagnosis and management of families at risk for CAH."

"[Latar belakang : Hipotiroid kongenital (HK) merupakan penyebab disabilitas intelektual yang dapat dicegah dan pencarian etiologinya belum menjadi prosedur rutin. Pencarian etiologi HK penting untuk dilakukan, karena membantu dalam menentukan derajat keparahan, mempengaruhi dosis substitusi L-tiroksin, terapi jangka panjang, prognosis, dan kemungkinan HK diturunkan pada anak selanjutnya (konseling genetik). Etiologi HK dapat bervariasi antar negara. Saat ini data mengenai etiologi HK di Indonesia masih sedikit.Tujuan : Mengevaluasi etiologi hipotiroid kongenital.Metode : Penelitian potong lintang dengan metode total sampling pada semua subjek yang terlibat dalam penelitian “Dampak keterlambatan diagnosis hipotiroid kongenital: disabilitas intelektual dan kualitas hidup pasien” di Jakarta. Penelitian ini dilakukan sejak lolos kaji etik sampai November 2014.Hasil : Terdapat 19 dari 25 subjek yang dapat dievaluasi etiologinya. Etiologi yang ditemukan adalah disgenesis (16/19) dan dishormonogenesis (3/16). Tipe disgenesis terbanyak berturut-turut adalah hemiagenesis (6/16), athireosis (5/16), hipoplasia (4/16), dan ektopik (1/16). Nilai IQ pada kelompok hipoplasia adalah borderline, sedangkan kategori nilai IQ etiologi lainnya adalah disabilitas intelektual. Rerata nilai IQ 72,7(SD 30,3) untuk kelompok hipoplasia, 58,2 (SD 16) untuk agenesis, 52,5 (SD 16,5) untuk hemiagenesis, 37,3 (SD 8) untuk dishormonogenesis, dan nilai IQ 46 didapatkan pada anak dengan kelenjar tiroid ektopik.Simpulan : Etiologi HK pada penelitian ini adalah disgenesis tiroid (16/19) dan dishormonogenesis (3/19). Hemiagenesis merupakan etiologi HK terbanyak (6/19). Hipoplasi tiroid merupakan kelompok dengan nilai IQ tertinggi (borderline) daripada kelompok lainnya (disabilitas intelektual).;Latar belakang : Congenital hypothyroidism (CH) is one of the most preventable cause of intellectual disability. Investigation for etiology of CH is not a routine procedure in Indonesia. Congenital hypothyroidism etiology is important for predict severity of hypothyroidism, L-thyroxine dose substitution, prognosis, and genetic counselling. Etiology of CH varies among countries. Current data about CH etiology in Indonesia is limited. This research is part of “Impact of delayed CH diagnosis: intellectual disability and quality of live” research that has been done in RSCM.Tujuan : To evaluate etiology of primary congenital hypothyroidism.Metode : A cross sectional study with total sampling of all participants in “Impact of delayed CH diagnosis: intellectual disability and quality of live” research. This research has been done since pass the ethics until November 2014.Hasil : There were 19 of 25 participants that could be evaluate the CH etiology. The etiology are dysgenesis (16/19) and dyshormomogenesis (3/19). Types of dysgenesis are hemiagenesis (6/16), athireosis (5/16), hypoplasia (4/16), and ectopic (1/16). Mean of total IQ was 72,7 (SD 30,3) for hypoplasia, 58,2 (SD 16) for agenesis, 52,5 (SD 16,5) for hemiagenesis, 37,3 (SD 8) for dyshormonogenesis, and IQ score for ectopic thyroid is 46.Simpulan : Etiology of Ch in this research is dysgenesis (16/19) and dyshormonogenesis (3/19). Hemiagenesis is the most common etiology in CH. Hypoplasia thyroid group has the highest IQ score (borderline) among other groups od etiology., Latar belakang : Congenital hypothyroidism (CH) is one of the most preventable cause of intellectual disability. Investigation for etiology of CH is not a routine procedure in Indonesia. Congenital hypothyroidism etiology is important for predict severity of hypothyroidism, L-thyroxine dose substitution, prognosis, and genetic counselling. Etiology of CH varies among countries. Current data about CH etiology in Indonesia is limited. This research is part of “Impact of delayed CH diagnosis: intellectual disability and quality of live” research that has been done in RSCM.Tujuan : To evaluate etiology of primary congenital hypothyroidism.Metode : A cross sectional study with total sampling of all participants in “Impact of delayed CH diagnosis: intellectual disability and quality of live” research. This research has been done since pass the ethics until November 2014.Hasil : There were 19 of 25 participants that could be evaluate the CH etiology. The etiology are dysgenesis (16/19) and dyshormomogenesis (3/19). Types of dysgenesis are hemiagenesis (6/16), athireosis (5/16), hypoplasia (4/16), and ectopic (1/16). Mean of total IQ was 72,7 (SD 30,3) for hypoplasia, 58,2 (SD 16) for agenesis, 52,5 (SD 16,5) for hemiagenesis, 37,3 (SD 8) for dyshormonogenesis, and IQ score for ectopic thyroid is 46.Simpulan : Etiology of Ch in this research is dysgenesis (16/19) and dyshormonogenesis (3/19). Hemiagenesis is the most common etiology in CH. Hypoplasia thyroid group has the highest IQ score (borderline) among other groups od etiology.]"

"[ABSTRAKLatar belakang: Obesitas pada anak merupakan predisposisi terjadinya obesitas saat dewasa yang berhubungan dengan timbulnya penyakit ko-morbiditas metabolik. Obesitas ditandai dengan penimbunan jaringan adiposa tubuh secara berlebihan sehingga menghasilkan sitokin dan mediator inflamasi yang berperan dalam terjadinya inflamasi subklinis.Tujuan: Untuk mengetahui profil penanda inflamasi subklinis pada anak obes usia 9-12 tahun melalui pemeriksaan sitokin inflamasi (Interleukin-6) dan protein fase akut (C-reactive protein dan alpha-1-acid glycoprotein).Metode: Penelitian deskriptif potong lintang yang dilakukan pada siswa SD obes dan non-obes usia 9-12 tahun di Jakarta Selatan dan bersedia diukur antropometri serta diperiksa laboratorium IL-6, CRP, dan AGP.Hasil: Dari 30 anak obes dan 30 anak non-obes didapatkan kadar median IL-6 anak obes lebih tinggi bila dibandingkan dengan anak non-obes yaitu 3,09 (1,16-6,49) vs 1,27 (0,51-3,86), kadar median CRP pada kelompok obes lebih tinggi dibandingkan kelompok non-obes, yaitu 2,25 (0,4-64) vs 0,2 (<0,2-2,6) dan kadar rerata AGP kelompok obes lebih tinggi dibandingkan kelompok non-obes, yaitu 93,13 ± 18,29 vs 71 ± 18,89.Simpulan: Inflamasi subklinis telah terjadi pada anak obes berusia 9-12 tahun. Kadar sitokin inflamasi IL-6, kadar protein fase akut CRP dan AGP lebih tinggi pada anak obes dibandingkan anak non-obes.

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ABSTRACTBackground: Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic co-morbidities. Obesity is basically an overt body adipose tissue which resulting cytokine and inflammatory mediators. The cytokine and inflammatory mediators play important role in subclinical inflammation.Objective: To describe subclinical inflammatory marker of obese children age 9-12 years old by examining inflammatory cytokine (Interleukin-6) and acute phase protein (C-reactive protein and alpha-1-acid glycoprotein).Methods: Cross sectional descriptive study was conducted in elementary school students of obese and non-obese age 9-12 years old in South Jakarta. Antropometric measurements and examination of IL-6, CRP, AGP were taken.Results: Thirty obese and thirty non-obese children were recruited in this study. Obese children showed higher median IL-6 compared to non-obese (3,09 (1,16-6,49) vs 1,27 (0,51-3,86)), higher median CRP in obese children compared to non-obese (2,25 (0,4-64) vs 0,2 (<0,2-2,6)). Obese children also showed higher mean AGP compared to non-obese (93,13 ± 18,29 vs 71 ± 18,89).Conclusions: Obese children age 9-12 years old have evidence of subclinical inflammation. The subclinical inflammation was based on higher IL-6, CRP, and AGP in obese children compared to non-obese children.;Background: Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic co-morbidities. Obesity is basically an overt body adipose tissue which resulting cytokine and inflammatory mediators. The cytokine and inflammatory mediators play important role in subclinical inflammation.Objective: To describe subclinical inflammatory marker of obese children age 9-12 years old by examining inflammatory cytokine (Interleukin-6) and acute phase protein (C-reactive protein and alpha-1-acid glycoprotein).Methods: Cross sectional descriptive study was conducted in elementary school students of obese and non-obese age 9-12 years old in South Jakarta. Antropometric measurements and examination of IL-6, CRP, AGP were taken.Results: Thirty obese and thirty non-obese children were recruited in this study. Obese children showed higher median IL-6 compared to non-obese (3,09 (1,16-6,49) vs 1,27 (0,51-3,86)), higher median CRP in obese children compared to non-obese (2,25 (0,4-64) vs 0,2 (<0,2-2,6)). Obese children also showed higher mean AGP compared to non-obese (93,13 ± 18,29 vs 71 ± 18,89).Conclusions: Obese children age 9-12 years old have evidence of subclinical inflammation. The subclinical inflammation was based on higher IL-6, CRP, and AGP in obese children compared to non-obese children.;Background: Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic co-morbidities. Obesity is basically an overt body adipose tissue which resulting cytokine and inflammatory mediators. The cytokine and inflammatory mediators play important role in subclinical inflammation.Objective: To describe subclinical inflammatory marker of obese children age 9-12 years old by examining inflammatory cytokine (Interleukin-6) and acute phase protein (C-reactive protein and alpha-1-acid glycoprotein).Methods: Cross sectional descriptive study was conducted in elementary school students of obese and non-obese age 9-12 years old in South Jakarta. Antropometric measurements and examination of IL-6, CRP, AGP were taken.Results: Thirty obese and thirty non-obese children were recruited in this study. Obese children showed higher median IL-6 compared to non-obese (3,09 (1,16-6,49) vs 1,27 (0,51-3,86)), higher median CRP in obese children compared to non-obese (2,25 (0,4-64) vs 0,2 (<0,2-2,6)). Obese children also showed higher mean AGP compared to non-obese (93,13 ± 18,29 vs 71 ± 18,89).Conclusions: Obese children age 9-12 years old have evidence of subclinical inflammation. The subclinical inflammation was based on higher IL-6, CRP, and AGP in obese children compared to non-obese children., Background: Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic co-morbidities. Obesity is basically an overt body adipose tissue which resulting cytokine and inflammatory mediators. The cytokine and inflammatory mediators play important role in subclinical inflammation.Objective: To describe subclinical inflammatory marker of obese children age 9-12 years old by examining inflammatory cytokine (Interleukin-6) and acute phase protein (C-reactive protein and alpha-1-acid glycoprotein).Methods: Cross sectional descriptive study was conducted in elementary school students of obese and non-obese age 9-12 years old in South Jakarta. Antropometric measurements and examination of IL-6, CRP, AGP were taken.Results: Thirty obese and thirty non-obese children were recruited in this study. Obese children showed higher median IL-6 compared to non-obese (3,09 (1,16-6,49) vs 1,27 (0,51-3,86)), higher median CRP in obese children compared to non-obese (2,25 (0,4-64) vs 0,2 (<0,2-2,6)). Obese children also showed higher mean AGP compared to non-obese (93,13 ± 18,29 vs 71 ± 18,89).Conclusions: Obese children age 9-12 years old have evidence of subclinical inflammation. The subclinical inflammation was based on higher IL-6, CRP, and AGP in obese children compared to non-obese children.]"

"[ABSTRAKLatar Belakang: Angka kejadian trombositopenia pada neonatus dilaporkan antara 22-35%, dan salah satu komplikasinya adalah perdarahan intraventrikular (PIV). Penelitian sebelumnya di Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta melaporkan angka kejadian PIV masih tinggi pada bayi usia gestasi < 35 minggu sebesar 43,47%. Perdarahan intraventrikular menyebabkan dampak yang berat pada perkembangan neurologis dan mortalitas. Di Indonesia, belum ada penelitian mengenai hubungan trombositopenia dan PIV. Tujuan: Mengetahui hubungan trombositopenia dengan PIV pada bayi usia gestasi < 35 minggu dan korelasi antara derajat berat trombositopenia dan derajat berat PIV. Metode: Penelitian potong lintang dengan penelusuran rekam medis dilakukan di Divisi Neonatologi Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia RSCM pada subjek yang dirawat pada bulan Januari 2012 sampai Desember 2014 dengan diagnosis PIV. Subjek dibagi menjadi kelompok PIV ringan sedang (derajat ≤ 2) dan berat (derajat > 2). Nilai trombosit dicatat pada hari yang sama dengan diagnosis PIV. Digunakan uji Pearson?s chi-square, Fischer, analisis multivariat, dan korelasi untuk analisis data. Hasil: Angka kejadian PIV berat dengan trombosit < 100.000/uL sebesar 28,2% dibanding 10,4% pada nilai trombosit ≥ 100.000/uL (p=0,014). Berdasarkan analisis multivariat, faktor yang memiliki pengaruh terhadap terjadinya PIV berat adalah usia gestasi < 32 minggu dan penggunaan alat bantu napas berupa ventilator dan high frequency oscillatory ventilation (HFOV). Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV (koefisien korelasi 0,21). Simpulan: Trombositopenia tidak memiliki peranan pada terjadinya PIV berat. Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV.

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ABSTRACTBackground: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson?s chi-squared, Fischer's tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn?t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH., Background: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson’s chi-squared, Fischer’s tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn’t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH.]"

"[ABSTRAKLatar Belakang: Terapi kombinasi antiretroviral (ARV)telah berhasil menurunkan angka morbiditas dan mortalitas pasien HIV, namun efek samping jangka panjang dapat menimbulkan perubahan distribusi lemak tubuh yang dikenal dengan sindrom lipodistrofi. Pasien HIV yang mengalami lipodistrofi berisiko mengalami gangguan metabolik yang dapat menyebabkan terjadinya penyakit kardiovaskular.Tujuan: Mengidentifikasi adanya lipodistrofi dan dislipidemia pada pasien prepubertas dengan HIV yang mendapatkan terapi ARV jangka panjang.Metode: Penelitian potong lintang dilakukan pada 76 pasien HIV usia prepubertas yang kontrol rutin di Poli Alergi Imunologi RSCM. Subyek dilakukan pemeriksaan klinis lipodistrofi oleh tenaga klinis terlatih menggunakan kriteria dari the European Paediatric Group of Lipodystrophy. Selain itu juga dilakukan pemeriksaan tebal lipatan kulit (TLK) triceps dan subscapular, lingkar pinggang, serta rasio lingkar pinggang-panggul. Data kadar CD4 awal, status gizi awal terdiagnosis, jenis terapi ARV, dan lama terapi ARV diambil dari rekam medis. Subyek juga dilakukan analisis diet, pemeriksaan profil lipid dan gula darah puasa.Hasil: Pada subyek prepubertas dengan HIV yang mendapatkan terapi ARV yang mengalami lipodistrofi dan dislipidemia berturut-turut sebanyak 47% dan 46%. Subyek yang mengalami lipodistrofi berupa lipohipertrofi (35%), lipoatrofi (5%), dan tipe campuran (7%). Subyek yang mengalami lipodistrofi pada umumnya memiliki massa lemak tubuh, serta TLK triceps dan subscapular yang normal. Pada subyek dengan lipohipertrofi dan tipe campuran seluruhnya memiliki rasio lingkar pinggang-panggul yang meningkat.Terdapat hubungan yang signifikan antara penggunaan regimen ARV kombinasi 2 nucleoside reverse transcriptase inhibitor (NRTI)+ protease inhibitor (PI) meningkatkan risiko 6,9 kali untuk terjadinya dislipidemia (p=0,001, IK95% 2,03-23,7) dibandingkan regimen 2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI).Simpulan: Prevalens lipodistrofi dan dislipidemia cukup tinggi pada pasien prepubertas dengan HIV yang mendapatkan terapi ARV. Pada umumnya subyek yang mengalami lipodistrofi pada penelitian ini adalah tipe lipohipertrofi.

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ABSTRACTBackground: Antiretroviral (ARV) combination therapy has significantly reduced morbidity and mortality in HIV-infected children. Long-term adverse effect of ARV is lipodystrophy syndrome. Lipodystrophy associated with metabolic disturbances which can cause cardiovascular disease.Objective: To identify lipodystrophy and dyslipidemia in prepubertal HIV-infected patients receiving long-term ARV therapy.Methods: Cross sectional study including 76 prepuberty HIV-infected children was performed by clinical and medical records review in Allergy Immunology Ward Cipto Mangunkusumo Hospital. Clinical examination of lipodystrophy was assesed by a trained clinician using the European Pediatric Group of Lipodystrophy criteria. We also assesed triceps and subscapular skinfold thicknesses, waist ratio, and waist-hip ratio. CD4 level and nutritional status at beginning therapy, ARV regiments, and duration ARV therapy were reviewed from medical records. We also performed diet analysis and laboratory examination such as lipid profiles and fasting glucose.Results: Prevalenceof lipodystrophy and dyslipidemia inprepubertalinfected-HIV children who receiving ARV were 47% and 46%. Subjects with lipodystrophy consisted of lipohypertrophy (35%), lipoatrophy (5%), and mixed type (7%). Subjects with lipodystrophy majority had normal triceps and subscapular skinfold thicknesses and normal total body fat. All subjects with lipohipertrophy and mixed type had an increasing waist-hip ratio. Regiment of 2 nucleoside reverse transcriptase inhibitors (NRTI) + protease inhibitor (PI) increased 6,9 times risk of dyslipidemia compare with 2NRTI+ non-nucleoside reverse transcriptase inhibitor (NNRTI) regiment (p=0,001, 95%CI 2,03-23,7).Conclusion: The prevalence of lipodystrophy and dyslipidemia are high among prepuberty HIV-infected children on antiretroviral therapy. Majority of subjects with lipodystrophy in this study were lipohypertrophy type., Background: Antiretroviral (ARV) combination therapy has significantly reduced morbidityand mortality in HIV-infected children. Long-term adverse effect of ARV is lipodystrophysyndrome. Lipodystrophy associated with metabolic disturbances which can causecardiovascular disease. Objective: To identify lipodystrophy and dyslipidemia in prepubertal HIV-infected patientsreceiving long-term ARV therapy.Methods: Cross sectional study including 76 prepuberty HIV-infected children wasperformed by clinical and medical records review in Allergy Immunology Ward CiptoMangunkusumo Hospital. Clinical examination of lipodystrophy was assesed by a trainedclinician using the European Pediatric Group of Lipodystrophy criteria. We also assesedtriceps and subscapular skinfold thicknesses, waist ratio, and waist-hip ratio. CD4 level andnutritional status at beginning therapy, ARV regiments, and duration ARV therapy werereviewed from medical records. We also performed diet analysis and laboratory examinationsuch as lipid profiles and fasting glucose. Results: Prevalenceof lipodystrophy and dyslipidemia inprepubertalinfected-HIV childrenwho receiving ARV were 47% and 46%. Subjects with lipodystrophy consisted oflipohypertrophy (35%), lipoatrophy (5%), and mixed type (7%). Subjects with lipodystrophymajority had normal triceps and subscapular skinfold thicknesses and normal total body fat.All subjects with lipohipertrophy and mixed type had an increasing waist-hip ratio. Regimentof 2 nucleoside reverse transcriptase inhibitors (NRTI) + protease inhibitor (PI) increased 6,9times risk of dyslipidemia compare with 2NRTI+ non-nucleoside reverse transcriptaseinhibitor (NNRTI) regiment (p=0,001, 95%CI 2,03-23,7).Conclusion: The prevalence of lipodystrophy and dyslipidemia are high among prepubertyHIV-infected children on antiretroviral therapy. Majority of subjects with lipodystrophy inthis study were lipohypertrophy type.]"