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"Latar Belakang Kelenjar tiroid merupakan salah satu kelenjar endokrin terbesar yang terletak di bawah kartilago tiroid. Kanker tiroid merupakan keganasan yang muncul dari sel parenkim tiroid yang mana sel sel tumbuh secara tidak normal dari jaringan kelenjar tiroid juga berpotensi menyebar ke bagian tubuh lainnya. Berdasarkan World Health Organization (WHO), data kanker tiroid di dunia pada tahun 2020 secara keseluruhan mencapai 586.202 kasus. Sementara, di Indonesia sendiri, kasus kanker tiroid pada tahun 2020 mencapai 13.114 dengan angka kematian mencapai 2.224 yang mana lebih banyak terjadi pada perempuan dengan jumlah 9.053 kasus. Berdasarkan penelitian, prevalensi kanker tiroid pada anak adalah 0,2-5 % dibandingkan dengan sekitar 30% pada orang dewasa. Melihat permasalahan ini, penelitian ini bertujuan untuk mengetahui prevalensi kanker tiroid pada anak di RSUPN Dr. Cipto Mangunkusumo yang belum ada datanya terutama berdasarkan karakteristik dan faktor risikonya. Metode Penelitian ini menggunakan metode observasional deksriptif dengan pendekatan cross sectional. Sampel yang digunakan berupa total sampling pada penderita kanker tiroid anak di RSCM periode 2016 hingga 2022.Hasil Hasil penelitian ini mendapatkan prevalensi kanker tiroid pada anak di RSCM pada Tahun 2016 – 2022 sebsar 1,4%. Dengan karakteristik sosiodemografi, 95,7% berusia 11 hingga 18 tahun, 78,3% berjenis kelamin perempuan dan 21,7% berjenis kelamin laki- laki, serta 65,2% tinggal di perkotaan. Hasil lainnya menunjukkan 95,7% riwayat keluarga tidak ada dan 47,8% mempunyai BMI ideal. Hasil karakteristik klinis, 78,3% pasien dengan jenis kanker tiroid papilar, 87% pasien stadium1, 43,5% mengalami T2, 39,1% mengalami N1, dan 13% dengan M1. Terapi utamanya operasi sebanyak 86,9% dengan jenis total tiroidektomi sebesar 60%. Tidak terdapat perbedaan karakteristik antara jenis kanker tiroid papilar dan folikular. Kesimpulan Penelitian ini memberikan angka prevalensi serta data deskriptif terkait persentase dan frekuensi masing-masing variabel yang dapat dijadikan acuan untuk penelitian selanjutnya berupa analitik terkait prognosis dan mortalitas serta hubungan setiap variabel.

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Introduction The thyroid gland is one of the largest endocrine glands which is located under the thyroid cartilage. Thyroid cancer is a malignancy that arises from thyroid parenchyma cells in which the cells grow abnormally from the thyroid gland tissue which also has the potential to spread to other parts of the body. Based on the World Health Organization (WHO), data on thyroid cancer in the world in 2020 reached 586,202 cases. Meanwhile, in Indonesia alone, cases of thyroid cancer in 2020 reached 13,114 with a death rate of 2,224 which was more common in women with a total of 9,053 cases. Based on research, the prevalence of thyroid cancer in children is 0.2 – 5% compared to about 30% in adults. Seeing this problem, this study aims to determine the prevalence of thyroid cancer in children at RSUPN Dr. Cipto Mangunkusumo for which there is no data, mainly based on the characteristics and risk factor.

Method This study used a descriptive observational method with a cross sectional approach. The sample used was total sampling in children with thyroid cancer at RSCM for the period 2016 to 2022.

Results The results of this study found that the prevalence of thyroid cancer in children at RSCM in 2016 - 2022 was 1.4%. With sociodemographic characteristics, 95.7% were aged 11 to 18 years, 78.3% were female and 21.7% were male, and 65.2% lived in urban areas. Other results showed that 95.7% had no family history and 47.8% had an ideal BMI. Results of clinical characteristics, 78.3% of patients had papillary thyroid cancer, 87% of patients had stage 1, 43.5% had T2, 39.1% had N1, and 13% had M1. The main therapy was surgery for 86.9% with total thyroidectomy at 60%. There are no differences in characteristics between papillary and follicular types of thyroid cancer.

Conclusion This research provides prevalence figures as well as descriptive data regarding the percentage and frequency of each variable which can be used as a reference for further research in the form of analytics related to prognosis and mortality as well as the relationship between each variable."

"Kanker payudara merupakan salah satu jenis kanker yang paling umum. Sebagaimana diketahui, kanker suatu jaringan dapat menyebar atau bermetastasis ke jaringan lain sebagai kanker sekunder, di mana pada kanker payudara 90% kematian selama pengobatan dikaitkan pada metastasis. Penelitian ini fokus kepada karakteristik metastasis bone only sebagai subtipe metastasis tulang kanker payudara yang belum banyak diteliti walaupun angka kelangsungan hidup (survival)nya paling bagus dibandingkan bila metastasis ke organ/tempat lainnya. Gambaran karakteristik pasien KPD BMO yg berobat di RSCM juga belum pernah diteliti. Penelitian ini menggunakan desain penelitian observasional deskriptif dengan desain studi cross sectional dengan teknik sampel total sampling. Terdapat 1278 pasien KPD metastasis yg berobat di RSCM 2017-2022. Didapatkan 148 pasien KPD BMO, namun karena ketidak lengkapan informasi di hasil pemeriksaan penunjang maka yang masuk kriteria inklusi penelitian ini adalah 47 pasien. Dari 47 pasien, ditemukan karakteristik 100% perempuan, rentang usia terbanyak 45-64 tahun (70,2%), 46,8% bersuku Jawa, 85,1% dalam usia menopause, dengan sebagian besar kanker karsinoma duktal invasif (85,1%) grade 2 (68,1%) dan subtipe luminal A (42,6%). Kasus Denovo sebanyak 48,9%. Ditemukan metastasis multiple (91,5%) lesi osteolitik(29,8%) , dan berlokasi di Os. Vertebrae (31,7%). Sejalan dengan penelitian sebelumnya dan faktor risiko metastasis bone only, sehingga dapat dilakukan studi lanjutan berupa studi analitik maupun genomic untuk mengkonfirmasi hubungan kausalitas tiap variabel.

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Breast cancer is one of the most common types of cancer. As we know, cancer in one tissue can spread or metastasize to other tissues as secondary cancer, where in breast cancer 90% of deaths during treatment are attributed to these metastases. This study focuses on the characteristics of bone only metastases as a subtype of breast cancer bone metastases that has not been widely studied although its survival is better than breast cancer which metastases to other organs. This research uses a descriptive observational research design with a cross sectional study design with a total sampling technique. We found 1278 breast cancer with metastasis treated in RSCM within 2017-2022. There are 148 breast cancer bone metastasis only, but only 47 patients were included in the research due to the completed radiology data. Of the 47 patients, the characteristics of the 47 patients were 100% female; 70,2% aged 45-64 years-old ;46,8% Javanese ; 85,1% in menopausal age, 68,1% with grade 2 invasive ductal carcinoma and 42,6% luminal A subtype; 48,9% Denovo cases ; 91,5% suffered from Multiple osteolytic lesion metastases and 31,7% were located in Os. Vertebrae. In line with previous research and risk factors for bone only metastasis, further studies can be carried out in the form of analytical or genomic studies to confirm the causal relationship between each variable."

"Latar belakang: Luka bakar adalah keadaan gawat darurat medis yang membutuhkan penanganan komprehensif sesuai dengan penyebab dan tingkat keparahan. Terapi resusitasi cairan sangat penting untuk mencegah atau mengatasi syok hipovolemik. Prinsipnya adalah memberikan cairan secara konservatif untuk mencapai tujuan resusitasi tanpa menyebabkan ekstravasasi cairan, yang dapat meningkatkan tekanan intraabdomen (TIA). TIA yang tinggi dan persisten dapat menyebabkan hipertensi intraabdomen (HIA) dan sindrom kompartemen abdomen (SKA). Formula Parkland tetap menjadi standar untuk resusitasi cairan, dengan menggunakan produksi urine (UO) sebagai penilaian kecukupan resusitasi.Metode: Subjek dalam penelitian ini adalah pasien luka bakar yang mendapatkan resusitasi cairan di ULB RSCM dan memenuhi kriteria inklusi dan eksklusi. Penelitian ini menggunakan desain studi cross sectional untuk mengetahui korelasi antara TIA dan UO dan bersumber dari data primer. Pengambilan data dilakukan selama fase resusitasi cairan 24 jam pertama. Pengukuran TIA dilakukan setiap 6 jam, sedangkan pengukuran UO dilakukan setiap 1 jam.Hasil: 12 pasien terinklusi dalam penelitian ini. Korelasi antara TIA dan UO 6 jam pertama bernilai lemah positif (r =0,225), pada 6 jam kedua korelasi lemah negatif (r = -0,226), pada 6 jam ketiga korelasi sedang negatif (r = -0,524), pada 6 jam keempat tidak terdapat korelasi (r = -0,120), pada korelasi secara keseluruhan selama 24 jam didapatkan korelasi lemah negatif (r = -0,208) tanpa adanya signifikansi secara keseluruhan (p > 0,05). Lebih lanjut, ditemukan korelasi antara %TBSA dengan jumlah cairan resusitasi selama 24 jam tergolong sangat kuat (r = 0,890) dan signifikan, korelasi antara %TBSA dengan rerata TIA selama 24 jam tergolong lemah positif (r = 0,226, p > 0,05), dan korelasi antara jumlah cairan resusitasi dan TIA rerata tergolong sedang positif (r = 0,467, p > 0.05).Kesimpulan: Tidak terdapat korelasi secara signifikan (p > 0.05) antara tekanan intraabdomen terhadap urine output pada pasien luka bakar selama fase 24 jam resusitasi cairan pertama di ULB RSCM.

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Introduction: Burns are urgent medical emergencies requiring comprehensive management based on etiology and severity. Fluid resuscitation therapy is crucial to prevent or manage hypovolemic shock. The principle is to administer fluid conservatively to achieve resuscitation goals without causing fluid extravasation, which can lead to intra-abdominal pressure (IAP) elevation. Persistent high IAP can result in intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). The Parkland formula remains standard for fluid resuscitation, utilizing urine output (UO) to assess adequacy.

Methods: Subjects in this study were burn patients who received fluid resuscitation at ULB RSCM and met the inclusion and exclusion criteria. This research uses a cross-sectional study design to determine the correlation between TIA and UO and is sourced from primary data. Data collection was carried out during the first 24 hours of fluid resuscitation phase. IAP measurements are carried out every 6 hours, while UO measurements are carried out every 1 hour.

Result: 12 patients were included in this study. The correlation between IAP and UO in the first 6 hours was weakly positive (r = 0.225), in the second 6 hours the correlation was weakly negative (r = -0.226), in the third 6 hours the correlation was moderately negative (r = -0.524), in the fourth 6 hours it was not there is a correlation (r = -0.120), in the overall correlation for 24 hours there is a weak negative correlation (r = -0.208) with no overall significance (p > 0.05). Furthermore, it was found that the correlation between %TBSA and the amount of resuscitation fluid for 24 hours was classified as very strong (r = 0.890) and significant, the correlation between %TBSA and average IAP for 24 hours was classified as weakly positive (r = 0.226, p > 0.05), and the correlation between the amount of resuscitation fluid and average IAP was moderately positive (r = 0.467, p > 0.05).

Conclusion: There is no significant correlation (p>0.05) between intra-abdominal pressure and urine output in burn patients during the first 24hour phase of fluid resuscitation at ULB RSCM."

"Tujuan dari penelitian ini adalah diketahuinya hasil simetrisasi bibir teknik operasi Fisher dibandingkan dengan teknik operasi Tennison-Randall, Millard dan Mohler berdasarkan studi dengan level of evidence (LOE). Penelitian ini adalah sebuah tinjauan sistematis dengan penelusuran basis data dari Google Scholar, Cochrane, Pubmed, ScienceDirect dan hand searching. Dilakukan seleksi studi dengan kriteria populasi celah bibir satu sisi tanpa sindrom, intervensi mencakup teknik operasi Fisher, dengan pembanding teknik operasi Tennison-Randall, Millard dan atau Mohler, keluaran simetrisasi bibir sesuai kriteria Steffensen dan studi sejak tahun 2012. Didapatkan total 255 studi dengan 4 studi terpilih memiliki desain studi uji klinis terkendali dan kohort tidak acak. Keempat studi terpilih membandingkan dengan teknik operasi Millard dan Mohler, tidak ada studi yang membandingkan dengan teknik operasi Tennison-Randall. Studi terpilih dilakukan analisis risk of bias (ROB), telaah kritis, analisis data dan sintesis kualitatif. Penilaian risiko bias dilakukan dengan Cohchrane risk of bias 2 dan ROBINS-I didapatkan risiko bias rendah pada keempat studi. Telaah kritis dilakukan dengan kriteria grading of recommendation, assessment, development and evaluation (GRADE) didapatkan nilai akhir yang rendah. Analisis data dari keempat studi didapatkan heterogenitas yang tinggi sehingga tidak dilanjutkan dengan metaanalisis. Keempat studi menilai keluaran kriteria Steffensen secara kuantitatif, pada satu studi terdapat perbedaan signifikan antara Fisher dengan Millard di mana hasil teknik operasi Millard lebih asimetris pada rasio tinggi bibir, tinggi vermilion dan lebar dasar hidung, tetapi perbedaan tersebut tersebut terlalu kecil untuk diamati orang awam. Pada keempat studi didapatkan kesimpulan yang sama pada penilaian subjektif kriteria Steffensen, keempat studi mengamati hasil simetrisasi teknik operasi Fisher lebih baik dibandingkan teknik lainnya. Hasil dari penelitian ini menyimpulkan bahwa hasil simetrisasi bibir teknik operasi Fisher lebih baik dibandingkan teknik operasi Millard dan Mohler. Penelitian ini tidak dapat menjawab perbandingan hasil simetrisasi bibir antara teknik operasi Fisher dengan teknik operasi Tennison-Randall. Hasil tersebut memiliki implikasi terhadap praktik berupa mendukung diterapkannya teknik operasi Fisher pada pasien dengan celah bibir satu sisi. Dukungan tersebut dapat dituangkan dalam kebijakan seperti rekomendasi panduan praktik klinis dengan kekuatan yang lemah

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The purpose of this research is to learn the lip symmetry results of the Fisher operative technique compared to the Tennison-Randall, Millard and Mohler operative techniques based on studies with the highest level of evidence (LOE). This research is a systematic review, inspecting the database from Google Scholar, Cochrane, Pubmed, ScienceDirect and also hand searching. Selection of studies was carried out with the criteria of a unilateral cleft lip population without syndrome, interventions included Fisher's operative technique, with comparison of Tennison-Randall, Millard and or Mohler operative techniques, lip symmetry outcome according to Steffensen's criteria and studies since 2012. A total of 255 studies were obtained with 4 studies selected having randomized clinical trial and non-randomized cohort study design. The four selected studies compared Fisher with Millard and Mohler operative techniques, none of the studies compared with the Tennison-Randall operative technique. Selected studies were evaluated for risk of bias (ROB), critical appraisal, data analysis and qualitative synthesis. The risk of bias assessment was carried out using the Cohchrane risk of bias 2 and ROBINS-I obtaining low risk of bias in all four studies. Critical review was carried out using the grading of recommendations, assessment, development and evaluation (GRADE) with a low final score. Data analysis from all four studies obtained high heterogeneity so it was not followed up with a meta-analysis. The four studies measured the Steffensen criteria quantitatively, in one study there was a significant difference between Fisher and Millard in that the results of Millard's operative technique were more asymmetric in the ratio of lip height, vermilion height and base width of the nose, but these differences were too small to be observed by the layman. In all four studies, the same conclusion was reached on the subjective criteria assessment of Steffensen, all four studies observed the lip symmetry results of the Fisher operation technique were better than other techniques. The results of this study concluded that the results of the Fisher operative technique's lip symmetry results were better than the Millard and Mohler operative techniques. This study cannot answer the comparison of lip symmetry results between Fisher's operative technique and Tennison-Randall's operative technique. These results have implications for daily practice that supports for the application of Fisher's operative technique to patients with unilateral cleft lip. Such support can be implemented in policies such as clinical practice guidelines recommendations with weak strength"

"Latar belakang: Chronic limb threatening ischemia (CLTI) merupakan bentuk terparah peripheral arterial disease. Pasien kaki diabetik dengan CLTI memiliki risiko amputasi mayor dan mortalitas paska revaskularisasi dan dipengaruhi beberapa faktor seperti usia lanjut, gagal ginjal kronik, komorbid penyakit jantung dan hipertensi. Indonesia belum memiliki data amputasi mayor dan mortalitas kaki diabetik dengan CLTI setelah revaskularisasi dan faktor-faktor yang berpengaruh. Penelitian ini bertujuan mengetahui angka amputasi mayor dan mortalitas satu tahun pasca revaskularisasi beserta faktor-faktor yang memengaruhi di Rumah Sakit Cipto Mangunkusumo (RSCM).Metode: Kohort retrospektif pasien kaki diabetik dengan CLTI setelah revaskularisasi di RSCM Januari 2010 – Desember 2020. Pengambilan data rekam medis. Luaran utama amputasi mayor dan mortalitas satu tahun setelah revaskularisasi. Dilakukan analisis bivariat dengan uji Kai Kuadrat, jika persyaratan tidak terpenuhi maka menggunakan Fischer-exact, variabel bermakna diuji lebih lanjut dengan regresi logistik. Hasil: Penelitian melibatkan 150 subjek. Amputasi mayor dan mortalitas satu tahun setelah revaskularisasi sebesar 27,3% dan 24,7%. Tidak didapatkan hubungan yang bermakna antara faktor-faktor yang diteliti dengan amputasi mayor dan mortalitas satu tahun.Kesimpulan: Didapatkan angka amputasi mayor dan mortalitas 1 tahun pasca revaskularisasi. Usia lanjut, gagal ginjal kronik, komorbid penyakit jantung dan hipertensi bukan merupakan faktor yang memengaruhi angka amputasi dan mortalitas satu tahun.

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Background: Chronic limb threatening ischemia (CLTI) is the most severe form of peripheral arterial disease. Diabetic foot patients with CLTI have major amputation and mortality risk after revascularization and affected by factors such as elderly, chronic kidney disease (CKD), cardiac morbidity and hypertension. In Indonesia there are no data regarding diabetic foot major amputation and mortality with CLTI after revacularization and influencing factors. Study aims to determine one year major amputation and mortality and factors that can affect diabetic foot pastients with CLTI after revascularization.

Methods: Retrospective cohort study on diabetic foot patients with CLTI undergoing revascularization at Cipto Mangunkusumo National Hospital from January 2010 to December 2020. The primary outcome was one-year major amputation and mortality after revascularization. Factors included were age, CKD, cardiac comorbidity and hypertension. We conducted bivariate analysis using Chi Square or Fisher-exact test. Variables were further tested using multivariate test.

Result: 150 subjects were enrolled. One-year major amputation and mortality was 27.3% and 24.7%. There are not significant correlations between factors with major amputation and mortality.

Conclusion: Major amputation and mortality rate one year after revascularization at RSCM are gained. Elderly, CKD, cardiac comorbidity and hypertension are not factors affecting one-year major amputation and mortality."

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Latar Belakang: Kanker hati, khususnya karsinoma sel hati (KSH), adalah masalah kesehatan utama secara global, dengan rekurensi dan tingkat kematian yang tinggi. Peradangan kronis dan stres oksidatif adalah faktor utama dalam perkembangan KSH. Studi sebelumnya menunjukkan bahwa parasetamol, obat anti-inflamasi umum, dapat mencegah KSH dengan menghambat jalur siklooksigenase (COX) dan mengurangi peradangan serta stres oksidatif. Penelitian ini bertujuan untuk mengetahui efek hepatoprotektif asetaminofen terhadap insiasi KSH oleh Diethylnitrosamine (DEN) pada tikus jantan.

Metode : Tikus Jantan jenis Sprague-Dawley (usia 5-6 minggu, Berat badan 240-290gr) dibagi kedalam kelompok kontrol dan perlakuan (masing-masing 6 tikus tiap kelompok) kedua kelompok diinisiasi KSH dengan injeksi DEN (50mg/kgBB) intraperitoneal setiap minggu selama 10 minggu. Kelompok perlakuan diberikan asetaminofen 200 mg/kg/hari peroral 1 minggu sebelum diberikan DEN sampai 24 minggu. Dilakukan pemeriksaan biomarka fungsi hati (AST, ALT,AFP, Bilirubin dan albumin) dan dilakukan pemeriksaan histopatologi sel hati. Data dianalisis menggunakan SPSS. Normalitas data dinilai dengan uji Shapiro-Wilk. Setelah itu, dilakukan uji analisis numerik tidak berpasangan berupa uji T-test tidak berpasangan

Hasil : Kelompok asetaminofen (perlakuan) menunjukkan perbedaan yang signifikan dalam nilai AST, ALT dan bilirubin dari waktu ke waktu serta nilai AST, ALT dan bilirubin yang lebih baik dari kelompok kontrol (p < 0.05). Tikus dalam kelompok kontrol mengalami kerusakan hati yang substansial dan kematian dini, sedangkan tikus dalam kelompok perlakuan menunjukkan peningkatan kelangsungan hidup dan fungsi hati yang lebih baik. Analisis histopatologis mengungkapkan lebih sedikit perubahan nekrotik dan prakanker pada kelompok perlakuan. Selain itu, tingkat albumin berhubungan signifikan dengan manifestasi sirosis (p = 0.005), dan tingkat ALT serta bilirubin berkorelasi dengan kondisi prakanker (p < 0.05).

Kesimpulan: Asetaminofen dengan dosis 200 mg/kg berat badan memiliki efek protektif pada hepatosit tikus terhadap kerusakan hati dan potensi karsinogenesis yang diinduksi oleh DEN. Studi ini dapat dikembangkan lebih lanjut untuk penelitian lanjutan yang mempertimbangkan penggunaan asetaminofen pada pasien dengan fibrosis hati yang menjalani reseksi hati untuk mencegah kekambuhan dan mengurangi peradangan pada pasien yang menjalani reseksi hati.

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Background: Liver cancer, particularly hepatocellular carcinoma (HCC), is a major global health issue, with high recurrence and mortality rates. Chronic inflammation and oxidative stress are key factors in the development of HCC. Previous studies have shown that paracetamol, a common anti-inflammatory drug, can prevent HCC by inhibiting the cylclooxygenase (COX) pathway and reducing inflammation and oxidative stress. This study aims to investigate the hepatoprotective effects of acetaminophen against diethylnitrosamine (DEN)-induced liver carcinoma in male rats.

Methods: Male Sprague-Dawley rats (5-6 weeks old, 240-290g) were divided into control and treatment groups (6 rats each). Both groups initiated HCC with DEN (50 mg/kg body weight) intraperitoneally once a week for 10 weeks. The treatment group additionally received acetaminophen (200 mg/kg/day) from one week before DEN administration until the 24th week. Liver function biomarkers (AST, ALT, AFP, Bilirubin and albumin) were measured, and liver tissues were histopathologically evaluated. Data were analyzed using SPSS, employing Shapiro-Wilk tests for normality and unpaired T-tests for comparisons.

Results: Acetaminophen group resulted in significant differences in Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), and bilirubin values over time and had better AST, ALT, bilirubin levels compared to control group (p < 0.05). Control group rats exhibited substantial liver damage and early death, whereas the treatment group showed improved survival and liver function. Histopathological analysis revealed fewer necrotic and pre-cancerous changes in the treatment group. Albumin levels were significantly associated with cirrhosis manifestation (p = 0.005), and ALT and bilirubin levels correlated with pre-cancerous conditions (p < 0.05).

Conclusions: Acetaminophen at 200 mg/kg body weight has protective effect on rat hepatocytes against DEN-induced liver damage and potential carcinogenesis. This study can be further developed for future research to be considered for use in patients with liver fibrosis undergoing liver resection to prevent recurrence and reduce inflammation in patients undergoing liver resection."

"Pendahuluan: Transpor neonatus dari unit neonatologi ke kamar operasi dan sebaliknya memiliki risiko terjadinya KTD (Kejadian tidak diharapkan) yang tinggi. Akan tetapi, belum ada studi terperinci yang mempelajari tentang hal tersebut. Studi ini ditujukan untuk mengetahui faktor-faktor risiko yang berperan dalam terjadinya KTD pada transfer perioperatif neonatus. Metode: Kami melakukan studi kohort retrospektif di RSUPN dr. Cipto Mangunkusumo. Neonatus yang memenuhi kriteria inklusi dan melalui kriteria eksklusi dilibatkan dalam penelitian ini. Faktor-faktor risiko serta profil KTD dihimpun dari neonatus yang terlibat. Analisis dilakukan secara komparatif univariat, bivariat, dan multivariat. Studi ini memiliki izin etik dari RSUPN dr. Cipto Mangunkusumo. Hasil: Tercatat sebanyak 87 KTD pada 56 neonatus yang menjadi subjek di dalam penelitian ini. Diketahui bahwa 51,79% subjek adalah perempuan, dengan 48,21% prematur, 58,93% berat badan lahir rendah, dengan rata-rata berat badan lahir 2.138 gram. Gambaran KTD terbanyak adalah desaturasi, mencakup 71,43%. Terdapat hubungan antara respiratory support invasif dengan hipotermia (OR = 0,052; IK 95% = 0,005 – 0,506). Terdapat hubungan antara respiratory support invasif dengan medical device adverse event (OR = 0,175; IK 95% = 0,043 – 0,707). Respiratory support invasif merupakan faktor yang paling berperan dalam medical device adverse event berdasarkan analisis multivariat (aOR = 0,023; IK 95% = 0,054–0,995). Angka kejadian KTD paling banyak pada kelompok satu kali transfer (64,29%), yaitu sebanyak 36 kasus dengan 13 (23,21%) di antaranya mengalami desaturasi. Terdapat hubungan antara frekuensi transfer pasien operasi unit neonatologi dan desaturasi (p-value = 0,047; Crude OR : 5,727 dan 95% CI : 1,148 - 28,573). Kesimpulan: Prematuritas, BBLR, dan kelainan kongenital tidak berhubungan dengan KTD. Sedangkan, penggunaan respiratory support invasif berhubungan dengan hipotermia dan medical device adverse event pada pasien transfer operasi unit neonatologi. Terdapat hubungan antara frekuensi transfer pasien dan KTD desaturasipada proses transfer neonates.

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Introduction: Transport of neonates from the neonatology unit to the operating room and vice versa carries a high risk of adverse events (KTD). However, there have been no detailed studies studying this. This study aims to determine the risk factors that play a role in the occurrence of adverse events during perioperative transfer of neonates. Methods: We conducted a retrospective cohort study at RSUPN dr. Cipto Mangunkusumo. Neonates who met the inclusion criteria and the exclusion criteria were included in this study. Risk factors and adverse event profiles were collected from the study subjects. Analysis was carried out using univariate, bivariate and multivariate analyses. This study was approved by RSUPN dr. Cipto Mangunkusumo. Results: A total of 87 adverse events were recorded in the 56 neonates who were subjects in this study. Fifty one point seventy nine percent of the subjects were female, 48.21% of the subjects were premature, 58.93% had low birth weight, with an average birth weight of 2,138 grams. The most common adverse event features were desaturation, covering 71.43% of the study subjects. There is a significant association between invasive respiratory support and hypothermia (OR = 0.052; 95% CI = 0.005 – 0.506). There is a significant association between invasive respiratory support and medical device adverse events (OR = 0.175; 95% CI = 0.043 – 0.707). Invasive respiratory support is the factor that plays the most role in medical device adverse events based on multivariate analysis (aOR = 0.023; 95% CI = 0.054–0.995). The highest incidence of adverse events (AEs) occurred in the single-transfer group (64.29%), with 36 cases, 13 (23.21%) of which experienced desaturation. There is a relationship between the frequency of patient transfers in the neonatal surgery unit and desaturation (p-value = 0.047; Crude OR: 5.727 and 95% CI: 1.148 - 28.573). Conclusion: Prematurity, LBW, and congenital abnormalities were not associated with adverse events. Meanwhile, the use of invasive respiratory support is associated with hypothermia and medical device adverse events in neonatology unit surgery transfer patients. There is a significant association between the frequency of patient transfers and desaturation adverse events during the transfer process of neonates. "

"Pendahuluan: Deep Vein Thrombosis (DVT) memiliki kecenderungan terus meningkat dengan koinsidensi mortalitas jangka pendek dan morbiditas jangka panjang. COVID-19 dapat menyebabkan hypercoagulable state dan menjadi predisposisi terjadinya DVT. Penelitian ini bertujuan untuk menganalisis hubungan kadar fibrinogen, D-Dimer, dan dosis heparin teraupetik berdasarkan kadar APTT dengan adanya COVID-19 pada pasien DVT. Metode: Desain penelitian komparatif dan kohort prospektif digunakan untuk membandingkan kadar fibrinogen, D-Dimer, dan dosis heparin terapeutik antara pasien COVID-19 dan non COVID-19 yang menderita DVT di RSPN Cipto Mangunkusumo pada bulan Maret 2020 – Maret 2022. Penegakan diagnosis DVT dilakukan dengan pemeriksaan ultrasonografi dan/atau computed tomography angiography (CTA) fase vena. Data variabel utama dan lainnya diperoleh dari rekam medis pasien. Uji T independen atau Mann-Whitney digunakan untuk menganalisis perbedaan nilai variabel antara kedua kelompok. Hasil: Dari total 253 sampel, tidak terdapat perbedaan karakterisitik awal antara kelompok DVT COVID-19 (n=44) dan DVT non COVID-19 (n=209), kecuali pada parameter Wells Score. Kelompok DVT COVID-19 memiliki kadar Fibrinogen, D-Dimer, dan aPTT yang lebih tinggi daripada kelompok DVT non COVID-19, baik sebelum terapi maupun sesudah terapi heparanisasi (semua nilai p =0,000). Pada akhir pengamatan, didapatkan dosis heparin terapeutik pada kelompok DVT COVID-19 lebih tinggi dibanding pada kelompok DVT non COVID-19 (30,00 (20,00-40,00)x103 U vs. 25,00 (20,00-35,00)x103 U, p=0,000). Kesimpulan: Kadar fibriongen, D-Dimer, dan dosis heparin terapeutik pada pasien DVT yang menderita COVID-19 lebih tinggi dibandingkan pada pasien DVT yang tidak menderita COVID-19. Inisiasi pemberian dosis heparin terapeutik dosis tinggi dapat dipertimbangkan pada pasien DVT dengan komorbid COVID-19 dan dipandu oleh hasil pemeriksaan biomarker koagulasi darah.

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Introduction: Deep Vein Thrombosis (DVT) has an increasing trend with a coincidence of short-term mortality and long-term morbidity. COVID-19 can cause a hypercoagulable state and predispose to DVT. This study aims to analyze the relationship between fibrinogen levels, D-Dimer, and therapeutic heparin doses based on APTT levels in the presence of COVID-19 in DVT patients. Methods: A comparative study design and a prospective cohort were used to compare levels of fibrinogen, D-Dimer, and therapeutic heparin doses between COVID-19 and non-COVID-19 patients suffering from DVT at Cipto Mangunkusumo Hospital in March 2020 – March 2022. Diagnosis of DVT was performed by ultrasound examination and/or computed tomography angiography (CTA) venous phase. The primary variable data and others were obtained from the patient's medical record. An Independent T-test or Mann-Whitney was used to analyze the differences in variable values between the two groups. Results: Of 253 samples, there was no difference in initial characteristics between the DVT COVID-19 (n=44) and non-COVID-19 DVT groups (n=209), except for the Wells Score parameter. The COVID-19 DVT group had higher levels of fibrinogen, D-Dimer, and aPTT than the non-COVID-19 DVT group, both before and after heparinization therapy (all p-values = 0.000). At the end of the follow-up period, the therapeutic dose of heparin in the COVID-19 DVT group was higher than in the non-COVID-19 DVT group (30.00 (20.00-40.00)x103 U vs. 25.00 (20.00-35.00)x103 U, p-value=0.000). Conclusion: The levels of fibrinogen, D-Dimer, and therapeutic doses of heparin in DVT patients who have COVID-19 are higher than in DVT patients who do not have COVID-19. Initiation of a higher therapeutic dose of heparin can be considered in DVT patients with comorbid COVID-19 and guided by the results of blood coagulation biomarkers."

"Stenosis atau oklusi vena sentral merupakan komplikasi serius pada pasien hemodialisis yang secara signifikan menurunkan kwalitas hemodialisis yang efektif patensi semua komponen akses vascular dialisis, termasuk arteri beserta cabangnya, AV anastomosis, vena perifer, dan vena sentral, sangat penting untuk penyediaan dialisis yang konsisten, kuat, nyaman, dan tidak rumit. Etiologi utama  stenosis vena sentral (SVS) sebagian besar adalah sekunder akibat penempatan kateter dialisis yang sementara ataupun menetap pada vena subclavia, vena  jugular internal, dan vena femoralis. Terapi endovascular standar stenosis vena sentral adalah angioplasty dengan balon konvensional.Analisis deskriptif dilakukan untuk menilai karakteristik serta sebaran data masing-masing variabel yang kemudian disajikan dalam bentuk tabuler atau grafik. Data kategorik disajikan dalam bentuk persentase dan dilakukan uji statistik dengan Chi-square atauFisher (univariat dan bivariat). Data yang akan dibandingkan adalah keberhasilan setelah tindakan Endo Vaskular dibandingkan antara riwayat pemasangan kateter vena sentral di vena subclavia dan vena jugularis interna, dengan tipe kateter, onset gejala, dan durasi pemasangan kateter sebagai variabel perancu.Dari hasil analisis data di temukan faktor-faktor bermakna yang berhubungan dengan keberhasilan tindakan Endo Vaskular pada pasien stenosis vena sentraldengan POBA (p>0.005) adalah ; onset gejalaklinis (<3 bulan), durasipemasangankateter (<2,5 bulan), riwayat pemasangan kateter sebelumnya (baru 1 kali), Initial stenosis (kurangdari 80), serta diameter POBA (> 10 mm). Diperlukan SOP untuk pemasangan KVS yang sesuai standar KADOQi untuk mengurangi resiko kejadian SVS.Diperlukan strategi screening yg lebih baik untuk mendeteksi  kasusSVS. Perlu edukasi kepada tenaga medis dan pasien mengenai durasi pemasangan KDL akut. Mengoptimalkan akses vaskuler permanen AVF sebagai Akses vaskular idaman penderita GGK yg menjalani HD.Perlu perhatian yang lebih dari pemerintah atau pihak penjamin kesehatan, karena keterbatasan biaya yang membuat tindakan Endo Vaskuler pada kasus SVS menjadi kurang optimal, terutama pada kasus re-Intervensi dan inisial stenosis yg berat (>80%).

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Central venous stenosis or occlusion is a serious complication in hemodialysis patients that significantly decreases effective hemodialysis quality The patency of all components of dialysis vascular access, including arteries and branches, AV anastomosis, peripheral veins and central veins, is essential for the provision of consistent, adequate dialysis, comfortable, and not complicated. The main etiologies of central venous stenosis (SVS) are mostly secondary to temporary or persistent dialysis / chemoteraphycatheter placement in the subclavian vein, internal jugular vein, and femoral vein. Standard endovascular therapy of central venous stenosis is angioplasty with conventional balloons.Descriptive analysis is done to assess the characteristics and distribution of data for each variable which is then presented in tabular or graphical form. Categorical data is presented in the form of a percentage and statistical tests are performed by Chi-square or Fisheries (univariate and bivariate). Data to be compared is the success after endovascular action compared between the history of central venous catheter placement in the subclavian vein and internal jugular vein, with, catheter type, symptom onset, and duration of catheter placement as confounding variables.The results of data analysis found significant factors related to the success of endovascular action in patients with central venous stenosis with POBA (p> 0.005) are; onset of clinical symptoms (<3 months), duration of catheter placement (<2.5 months), history of catheter placement (only 1 time), initial stenosis (less than 80), and diameter of POBA (> 10 mm).According with KADOQi standards is needed to reduce the risk of SVS events. A better screening strategy is needed to detect SVS cases. Need education to medical staff and patients regarding the duration of the installation of acute KDL. Optimizing AVF permanent vascular access as ideal vascular access for people with CRF who undergo HD. More attention is needed from the government or health guarantor, because of the limited costs that make endovascular actions in SVS cases less optimal, especially in cases of re-intervention and severe initial stenosis (> 80%)."

"Latar belakang: Ulkus Kaki diabetik atau Diabetic Foot Ulcer merupakan salah satu komplikasi yang berat, karena sering kali ulkus kaki diabetik berakhir dengan amputasi kecacatan dan kematian. USG Doppler merupakan modalitas yang mudah tersedia dan non invasif untuk evaluasi arteri ekstremitas inferior dan dapat mendeteksi tingkat keparahan gangguan aliran darah atau Penyakit Arteri Perifer (PAP) dengan sensitivitas 42,8% dan spesifisitas 97,5%. WHO merekomendasikan klasifikasi Perfusion, Extent/Size, Depth/Tissue Loss, Infection, Sensation (PEDIS) sebagai sarana penegakan diagnosis dan membantu menentukan tatalaksana kaki diabetik. Penelitian ini dilakukan untuk melihat korelasi skor PEDIS dalam menilai gangguan aliran arteri tungkai berdasarkan spektral USG Doppler pada penderita ulkus kaki diabetik di RS Cipto Mangunkusumo Jakarta. Subjek dan Metode: Subjek penelitian adalah pasien ulkus kaki diabetes yang dirawat di Divisi Bedah Vaskular dan Endovaskular FKUI-RS Cipto Mangunkusumo Jakarta dan memenuhi kriteria inklusi dan eksklusi. Penelitian ini dilakukan dengan perhitungan menggunakan sensitivitas estimasi sebesar 80%, error absolut (d=5%), prevalensi estimasi 51,8% maka besar sampel minimal adalah 76. Setelah itu diperoleh data berupa skor PEDIS dan hasil spektral USG pada arteri femoralis, arteri poplitea, arteri dorsalis pedis dan arteri tibialis posterior. Penelitian ini mengumpulkan 81 orang subjek dengan 52 orang (64%) jenis kelamin laki-laki, 29 orang (36%) perempuan dan rata-rata usia 59,8+10,5 tahun. Profil gula darah sewaktu subjek median 265 mg/dl dengan kisaran antara 105-571 mg/dl. Pada tabel 3 dalam menentukan Cut Off skor PEDIS menggunakan kurva ROC (Receiver Operating Characteristic), didapatkan Cut Off arteri poplitea >10, sedangkan arteri dorsalis pedis dan arteri tibialis posterior >8.

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Main topics: Diabetic Foot Ulcer or Diabetic Foot Ulcer is one form that is severe, because often diabetic foot ulcers end with disability amputation and death. Doppler ultrasound is an easily available and unlimited modality for lower limb risk and can detect the severity of arterial disease or peripheral arterial sensitivity (PAP) with a sensitivity of 42.8% and specificity of 97.5%. WHO that performs Data Perfusion, Area/Size, Depth/Tissue Loss, Infection, Sensation (PEDIS) as a means of enforcing the diagnosis and helps determine the management of diabetic foot. This study was conducted to look at the PEDIS score in assessing the disturbance of limb arterial flow based on Doppler ultrasound in patients with diabetic foot ulcer at Cipto Mangunkusumo Hospital, Jakarta. Subjects were patients with diabetic foot ulcers performed in the Division of Vascular and Endovascular Surgery of the Faculty of Medicine-Cipto Mangunkusumo Hospital Jakarta and fulfilled the inclusion and exclusion criteria. This research was conducted by calculating using an estimation sensitivity of 80%, absolute error (d = 5%), the largest prevalence of 51.8%, then the minimum sample size was 76. After that data was obtained in the form of PEDIS scores and spectral results of ultrasound in the femoral artery, arteries poplitea, dorsalis pedis artery and posterior tibial artery. This study collected 81 subjects with 52 people (64%) male gender, 29 people (36%) women and an average of 59.8 + 10.5 years. The blood sugar profile was median 265 mg/dl with a range of 105-571 mg/dl. In table 3 in determining the PEDIS score Cut-Off using the Receiver Operating Characteristic curve, obtained Cut-ff popliteal artery> 10, while the dorsalis pedis artery and posterior tibial artery> 8."