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"[ABSTRAKNeuroblastoma merupakan keganasan pada sistem saraf simpatik yang menimbulkan pembengkakanpada bagian tubuh tertentu. Pola hidup tidak sehat dari segi asupan nutrisi dan lingkungan menjadipenyebab utama munculnya neuroblastoma pada masyarakat perkotaan. Masalah nyeri kronikmerupakan komplikasi utama dari hampir semua jenis keganasan, termasuk neuroblastoma. Studi inibertujuan untuk menganalisis intervensi pemberian teknik distraksi dengan media video dan musikdalam mengurangi nyeri pada penderita neuroblastoma. Teknik distraksi memberikan hasil yangpositif berupa penurunan skala nyeri klien. Hasil karya ilmiah ini diharapkan dapat menjadi salah satupertimbangan bagi perawat ruangan untuk meningkatkan pemberian manajemen nyerinonfarmakologis, terutama teknik distraksi, sebagai salah satu intervensi yang telah terbukti efektifdalam menurunkan nyeri.

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ABSTRACTNeuroblastoma defined as a neoplasm of sympathetic nervous system which causes swelling in relatedpart of body. Unhealthy lifestyles such as nutritional and environmental factors are two main causesof neuroblastoma in urban population. Chronic pain is a major complication of any kind of cancers,including neuroblastoma. This study aimed to analyze the distraction technique as given interventionto reduce the pain scale in patients with neuroblastoma. The implementation of distraction techniqueshowed positive result in decreasing patient?s pain scale. The result can be considered as analternative nursing intervention to increase the usage of non pharmacological management of pain,mainly distraction technique, as an effective intervention to decrease pain scale.;Neuroblastoma defined as a neoplasm of sympathetic nervous system which causes swelling in relatedpart of body. Unhealthy lifestyles such as nutritional and environmental factors are two main causesof neuroblastoma in urban population. Chronic pain is a major complication of any kind of cancers,including neuroblastoma. This study aimed to analyze the distraction technique as given interventionto reduce the pain scale in patients with neuroblastoma. The implementation of distraction techniqueshowed positive result in decreasing patient?s pain scale. The result can be considered as analternative nursing intervention to increase the usage of non pharmacological management of pain,mainly distraction technique, as an effective intervention to decrease pain scale., Neuroblastoma defined as a neoplasm of sympathetic nervous system which causes swelling in relatedpart of body. Unhealthy lifestyles such as nutritional and environmental factors are two main causesof neuroblastoma in urban population. Chronic pain is a major complication of any kind of cancers,including neuroblastoma. This study aimed to analyze the distraction technique as given interventionto reduce the pain scale in patients with neuroblastoma. The implementation of distraction techniqueshowed positive result in decreasing patient’s pain scale. The result can be considered as analternative nursing intervention to increase the usage of non pharmacological management of pain,mainly distraction technique, as an effective intervention to decrease pain scale.]"

"Introduction of new technologies and their applications to neuroblastoma diagnosis, treatment, and therapy assessment are explained. Role of molecular ghenetics in diagnosis and therapy for neuroblastoma patients is detailed. Molecular detection of minimal residual neuroblastoma is described. Magnetic resonance imaging and spectroscopy are detailed for diagnosing this solid, extracranial cancer. Targets for therapeutic intervention in neuroblastoma are identified, including targeting multidrug resistance in this cancer. Ornithine decarboxylase and polyamines are novel targets for therapeutic intervention. The effectiveness of chemotherapy with oral irinotecan and temozolomide is explained. The role of transcription factors (GATA) in neuroblastoma pregression is also included."

"Latar Belakang: Prevalensi kanker di Indonesia meningkat menjadi 1,8 per 1000 penduduk pada 2018. Diagnosis dini yang tepat dibutuhkan untuk mengurangi angka mortalitas. Salah satu cara diagnosis tumor berupa pemeriksaan penanda tumor, seperti vanillylmandelic acid (VMA). Penanda tumor tersebut termasuk metabolit katekolamin yang akan meningkat produksinya pada beberapa tumor neuroendokrin. Kadar katekolamin sendiri dapat dipengaruhi oleh usia dan jenis kelamin. Belum ada data proporsi VMA positif dalam urin pada pasien dugaan tumor neuroendokrin di Jakarta serta hubungan VMA dalam urin dengan usia dan jenis kelamin. Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui proporsi VMA positif dalam urin pasien dugaan tumor neuroendokrin di Jakarta serta hubungannya dengan usia dan jenis kelamin. Metode: Penelitian ini menggunakan desain penelitian cross-sectional. Data sekunder dikumpulkan berupa lembar hasil serta formulir pemeriksaan VMA pasien dugaan tumor neuroendokrin pada periode 2010 hingga April 2019. Data didapatkan dari Departemen Biokimia dan Biologi Molekuler, FKUI. Pengambilan data sekunder dilakukan pada Oktober 2019 dengan total subjek penelitian 295. Pemeriksaan kualitatif VMA dalam urin dilakukan dengan metode spot test. Hasil pemeriksaan positif menunjukkan kadar VMA dalam urin > 8 mg/24 jam, sedangkan hasil negatif menunjukkan kadar VMA dalam urin  8 mg/24 jam. Kriteria inklusi berupa data subjek dengan diagnosis sementara neuroblastoma, pheochromocytoma, dan paraganglioma. Hasil: Proporsi VMA positif dalam urin pasien dugaan tumor neuroendokrin dalam penelitian ini adalah 14,2% (IK95%, 10,2 – 18,2%). Analisis hubungan VMA dalam urin dengan usia memberikan hasil p 0,023. Analisis hubungan VMA dalam urin dengan jenis kelamin menunjukkan hasil p 0,885. Kesimpulan: Terdapat hubungan antara VMA dalam urin dengan usia dan tidak terdapat hubungan antara VMA dalam urin dengan jenis kelamin.

Kata kunci: Vanillylmandelic Acid, Tumor Neuroendokrin, Neuroblastoma, Pheochromocytoma, Paraganglioma.

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Background: Cancer prevalence in Indonesia increased to 1.8 per 1000 population in 2018. Early diagnosis is needed to reduce mortality rate. One of the ways to diagnose tumors is by examining tumor markers, such as vanillylmandelic acid (VMA). VMA is catecholamine metabolites which will increase their production in several neuroendocrine tumors. Catecholamine level can be influenced by age and gender. There is no data about proportion of positive VMA in urine of patients with suspected neuroendocrine tumors in Jakarta and the association of VMA in urine with age and gender. Objective: The objective of this study was to determine the proportion of positive VMA in urine of patients with suspected neuroendocrine tumors and its association with age and gender. Methods: This study used a cross-sectional study design. Secondary data were collected in the form of VMA examination forms and result sheets from patients with suspected neuroendocrine tumors in the period 2010 to April 2019. Data were obtained from the Department of Biochemimstry and Molecular Biology, FKUI. Collection of secondary data conducted in October 2019 with a total of 295 study subjects. Qualitative examination of urinary VMA used spot test method. Positive examination result  showed levels of VMA in urine >8mg/24 hours, while negative result showed levels of VMA in urine  8mg/24 hours. Inclusion criteria were subject data with a provisional diagnosis of neuroblastoma, pheochromocytoma, and paraganglioma. Results: The proportion of positive VMA in urine of suspected neuroendocrine tumor patients in this study was 14,2% (CI95%, 10,2 – 18,2%). Analysis of the association between VMA in urine and age result was p value 0,023. P value form analysis of the association between VMA in urine and gender was 0,885. Conclusion: There is an association between VMA in urine with age and there is no association between VMA in urine with gender.

Keywords: Vanillylmandelic Acid, Neuroendocrine Tumors, Neuroblastoma, Pheochromocytoma, Paraganglioma.

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"Latar Belakang: Lebih dari 50 % kasus neuroblastoma datang dengan stage lanjut. Untuk itu, perlu upaya deteksi dini kasus neuroblastoma agar terapi menjadi lebih tepat dan terarah. Salah satu upaya deteksi dini tumor adalah dengan dengan menemukan mikro RNA (miRNA) yang berpotensi sebagai petanda hayati. Jenis tumor yang berbeda mengekspresikan profil miRNA yang berbeda pula. Dengan meneliti profil miRNA pada penderita neuroblastoma, maka bisa diketahui miRNA mana yang berperan sebagai petanda hayati neuroblastoma. Metode: Mikro RNA yang terkandung di dalam eksosom plasma diekstraksi dan disekuens dengan teknologi Next Generation Sequencing menggunakan mesin MiSeq. Data yang didapat menjalani normalisasi dan dilakukan analisis lanjutan yakni mencari miRNA yang terekspresi signifikan secara statistik di sampel plasma dan jaringan terkait dengan stage (M vs Non M), luaran (Meninggal vs Hidup), dan status amplifikasi gen MYCN (teramplifikasi atau tidak). Hasil: Pada parameter stage, terdapat 40 miRNA pada plasma dan 20 miRNA pada jaringan yang terekspresi signifikan. Di parameter luaran, terdapat 35 miRNA pada plasma dan 39 miRNA pada jaringan yang terekspresi signifikan. Pada analisis MYCN, terdapat 11 miRNA pada plasma dan 110 miRNA pada jaringan yang terekspresi signifikan. Mikro RNA-375 ter-upregulated secara signifikan pada stage M. Pada parameter luaran, miRNA-92a-3p ter-upregulated secara signifikan pada luaran meninggal. Mikro RNA 92a-3p dan miR-99a-5p ter-upregulated secara signifikan pada sampel yang terdapat amplifikasi gen MYCN. Kesimpulan: Mikro RNA 375 terekspresi signifikan pada parameter stage M. Mikro RNA 92a-3p terekspresi signifikan pada parameter luaran meninggal. Mikro RNa 92a-3p dan miR-99a-5p terekspresi signifikan pada parameter gen MYCN teramplifikasi. Ketiga miRNA ini, yakni miR-375, miR-92a-3p, miR-99a-5p berpotensi menjadi petanda hayati pada neuroblastoma.

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Background: More than 50 % of neuroblastoma cases present in advance stage. An early detection effort is needed to direct the treatment with precision. One such effort is to find potential micro RNA (miRNA) that functions as biomarker. Different tumor type produces different miRNA expression profile. The study of miRNA profile in neuroblastoma may pave way to identify potential miRNA that may play role as biomarker in neuroblastoma.

Methods: Exosomal miRNA were extracted and sequenced using MiSeq, a Next Generation Sequencing platform machine. The counts obtained underwent normalization and further analysis of significantly expressed miRNA in stage (M vs Non M), Output (Deceased or Alive), and MYCN gene amplification (present or not) in both plasma and tissue samples were done.

Results: In stage parameter, there were 40 and 20 miRNAs significantly expressed in plasma and tissue. In output parameter, there were 35 and 39 miRNAs significantly expressed in plasma and tissue. In MYCN parameter, there were 11 and 110 miRNAs significantly expressed in plasma and tissue. Micro RNA-375 was significantly upregulated in stage M. In output parameter, miRNA-92a-3p was significantly upregulated in deceased cases. Micro RNA 92a-3p and miR-99a-5p were significantly upregulated in samples with amplified MYCN gene.

Conclusion: Micro RNA 375 was significantly expressed in stage M. Micro RNA 92 a- 3p was significantly expressed in deceased cases. Micro RNA 92a-3p and miR-99a-5p were significantly expressed in amplified MYCN samples. Those three miRNAs, miR- 375, miR-92a-3p, miR-99a-5p have potential to be biomarkers for neuroblastoma."