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"ABSTRAKPendekatan integrasi antara terapi paliatif dan perawatan penyakit kronik dan atau mengancam jiwa telah banyak digunakan dalam beberapa tahun terakhir. Hingga saat ini, masih banyak yang beranggapan bahwa terapi paliatif hanya ditujukan untuk pasien dengan penyakit berat yang sudah berada di stadium terminal atau akhir hidupnya, namun pada kenyataannya banyak pasien mendapatkan manfaat dari terapi paliatif sedini mungkin. Penelitian ini merupakan uji klinis acak terkontrol yang bertujuan untuk mengetahui manfaat integrasi terapi paliatif pada pasien anak dengan penyakit keganasan. Pasien terdiri dari anak dengan penyakit keganasan usia 2-18 tahun yang dikonsulkan kepada tim paliatif. Pasien dibagi menjadi dua kelompok secara acak, yakni kelompok kontrol (30 anak) dan kelompok intervensi (30 anak). Intervensi berupa kunjungan rumah, komunikasi dua arah antara tenaga terlatih dengan pasien dan orang tua, dibagi menjadi 6 sesi (1 sesi setiap 2 minggu) yang berfokus pada edukasi penyelesaian masalah, manajemen gejala, perawatan diri sendiri, komunikasi, pembuatan keputusan dan pendampingan rencana perawatan lanjutan. Pasien diikuti dan dilakukan penilaian kualitas hidup dengan kuesioner Pediatric Quality of Life Innitiative (PedsQLTM) modul kanker 3.0, intensitas gejala dinilai dengan Edmonton Symptoms Assesment Score (ESAS), frekuensi kunjungan unit gawat darurat (UGD) pasien anak dengan penyakit keganasan dicatat selama periode penelitian dan dibandingkan dengan sebelum penelitian. Kelompok intervensi memiliki kualitas hidup lebih tinggi bermakna (81,63) dibandingkan kelompok kontrol (62,39), p<0,001. Ranah kualitas hidup yang paling meningkat secara signifikan adalah ranah nyeri, mual, kecemasan prosedur, kecemasan tata laksana, dan khawatir. Intervensi paliatif dapat menurunkan intensitas gangguan tidur (p=0,003) dan anoreksia pada pasien (p<0,001). Intervensi paliatif dapat menurunkan kunjungan UGD sebanyak 4,77 kali pada pasien anak dengan penyakit keganasan (OR 4,77, 95% IK 1,29-17,65; p=0,018).

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ABSTRACTIn these last few years, an integrated approach between palliative care and chronic and/or life-threatening conditions care have been widely used. Many people think that palliative care is only intended for those with end stage of disease or in the end of life period. In fact, many patients had benefit from early palliative integration. This study is aimed to know the role of palliative intervention in child with malignancy. A randomized controlled trial comparing patients who were given palliative care (a 3-month home visit) and those who were not (intervention vs control group) was conducted, each group containing 30 patients. Patients consisted of children with cancer aged 2-18 years old who were consulted to palliative team. A two-way communication between a trained health worker and patients with or without their parents were conducted as the intervention (report by proxy or self-report). Interventions were given in 6 sessions (1 session every 2 weeks) focusing on problems solving education, symptoms management, self-care, communication, decision making, and long-term care plan assistance. In the first and twelfth week of the intervention, all patients were assessed with the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0. Symptomps intensity were assessed by Edmonton Symptoms Assesment Score (ESAS). Emergency room admissions from the last 3 months were noted before patients were enrolled in the study. During the follow up period, ER admissions were recorded further. Data was analyzed using bivariate analysis, OR calculations were performed to see the effect of interventions on outcomes in this study. A significant difference of quality of life was found between the two groups with average total score in control group 62.39 and intervention group 81.63 (p<0.001). Most significant increased domains were pain, nausea, procedural anxiety, treatment anxiety, and worry. Intensity of sleep disturbance (p=0.003) and anorexia (p<0.001) were decreased significantly in intervention group. Emergency room admissions were reduced by 4.7 times in intervention group (OR 4.77, 95% CI 1.29-17.65; p=0.018)."

"Karya Ilmiah Akhir ini memberikan gambaran tentang pelaksanaan Program Residensi Ners Spesialis Keperawatan Anak dalam bentuk kegiatan praktik Residensi I dan II. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi Model Konservasi Myra E. Levine pada asuhan keperawatan anak dengan penyakit infeksi dan pencapaian kompetensi baik sebagai pemberi asuhan, advocator, conselor, educator, colaborator, dan agen perubah selama praktik residensi. Ada lima kasus kelolaan yang menjadi pembahasan dalam karya ilmiah ini, dan dari kelima kasus terpilih ditemukan adanya masalah ketidakseimbangan nutrisi kurang dari kebutuhan. Intervensi yang diberikan berdasarkan pinsip-prinsip konservasi sudah mencakup semua masalah yang ditemukan pada klien, walaupun tidak semua masalah dapat terselesaikan Hasil evaluasi pada akhir perawatan dari trophicognosis ketidakseimbangan nutrisi kurang dari kebutuhan pada kelima kasus terpilih, menunjukkan ada yang teratasi, belum teratasi tetapi sudah menunjukkan perbaikan, dan ada juga yang belum teratasi.

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This final assignment provides an overview about the implementation residency practices of the specialist pediatric nurse program in the form practical activities residency I and II. The aim of this final assignment is provide overview application Conservation Model Myra E. Levine on nursing care of children with infectious diseases and the achievement of competencies such as a caregiver advocator, counselor, educator, collaborator, and change agents during practice. There are five cases that discussed in this final assignment, and of the five selected cases found a problem with imbalance nutrition less than demand. Interventions provided by conservation principles have covered all the problems found on the client, although not all problems can be resolved. The evaluation results of trophicognosis imbalance nutrition less than the needs of the five selected cases, indicating there are resolved, not resolved but has shown improvement, and there are also unresolved."

"Diarrhea poses significant health risks in developing countries like Indonesia, especially among children, contributing to high morbidity and mortality rates according to the 2018 World Health Organization report. The escalating antimicrobial resistance among enteric pathogens in these nations is also a critical concern. The aim of this research is to profile Gram-negative bacteria in pediatric patients with diarrheal conditions and analyze the antibacterial gene resistance of Gram-negative bacteria in these patients. Stool samples were cultured and sent to the FKUI Microbiology Laboratory for DNA isolation. Pathogenic Gram-negative bacteria were identified and sequenced at the Bioinformatics Core Facilities at IMERI-FKUI using Next-Generation Sequencing (NGS). Antibiotic resistance to antibiotics such as cefixime, co-trimoxazole, ciprofloxacin, and carbapenem was determined. Eighteen bacterial samples revealed a diverse landscape of Klebsiella pneumoniae and E. coli strains. Klebsiella pneumoniae predominated (56%), with various Sequence Types (STs) and phylotypes identified. Notably, ST-231 and ST-101 were associated with the K1 phylotype, indicating potential virulence. E. coli (44% of samples) showed a spectrum of pathogenicity, including ExPEC as the most prevalent. Virulence gene analysis highlighted complex pathogenic mechanisms and significant antibiotic resistance, especially in E. coli. K. pneumoniae and E. coli isolates showed high resistance to multiple antibiotics, including fluoroquinolones, fosfomycin, aminoglycosides, and beta-lactams. This research enhances the understanding of gastrointestinal health in children and underscores the urgent need for effective antimicrobial stewardship to combat antimicrobial resistance."

"Pendekatan integrasi antara terapi paliatif dan perawatan penyakit kronik dan atau mengancam jiwa telah banyak digunakan dalam beberapa tahun terakhir. Hingga saat ini, masih banyak yang beranggapan bahwa terapi paliatif hanya ditujukan untuk pasien dengan penyakit berat yang sudah berada di stadium terminal atau akhir hidupnya, namun pada kenyataannya banyak pasien mendapatkan manfaat dari terapi paliatif sedini mungkin. Penelitian ini merupakan uji klinis acak terkontrol yang bertujuan untuk mengetahui manfaat integrasi terapi paliatif pada pasien anak dengan penyakit keganasan. Pasien terdiri dari anak  dengan penyakit keganasan usia 2-18 tahun yang dikonsulkan kepada tim paliatif. Pasien dibagi menjadi dua kelompok secara acak, yakni kelompok kontrol (30 anak) dan kelompok intervensi (30 anak). Intervensi berupa kunjungan rumah, komunikasi dua arah antara tenaga terlatih dengan pasien dan orang tua, dibagi menjadi 6 sesi (1 sesi setiap 2 minggu) yang berfokus pada edukasi penyelesaian masalah, manajemen gejala, perawatan diri sendiri, komunikasi, pembuatan keputusan dan pendampingan rencana perawatan lanjutan. Pasien diikuti dan dilakukan penilaian kualitas hidup dengan kuesioner Pediatric Quality of  Life Innitiative (PedsQLTM) modul kanker 3.0, intensitas gejala dinilai dengan Edmonton Symptoms Assesment Score (ESAS), frekuensi kunjungan unit gawat darurat (UGD) pasien anak dengan penyakit keganasan dicatat selama periode penelitian dan dibandingkan dengan sebelum penelitian. Kelompok intervensi memiliki kualitas hidup lebih tinggi bermakna (81,63) dibandingkan kelompok kontrol (62,39), p<0,001. Ranah kualitas hidup yang paling meningkat secara signifikan adalah ranah nyeri, mual, kecemasan prosedur, kecemasan tata laksana, dan khawatir. Intervensi paliatif dapat menurunkan intensitas gangguan tidur (p=0,003) dan anoreksia pada pasien (p<0,001). Intervensi paliatif dapat menurunkan kunjungan UGD sebanyak 4,77 kali pada pasien anak dengan penyakit keganasan (OR 4,77, 95% IK 1,29-17,65; p=0,018).

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In these last few years, an integrated approach between palliative care and chronic and/or life-threatening conditions care have been widely used. Many people think that palliative care is only intended for those with end stage of disease or in the end of life period. In fact, many patients had benefit from early palliative integration. This study is aimed to know the role of palliative intervention in child with malignancy. A randomized controlled trial comparing patients who were given palliative care (a 3-month home visit) and those who were not (intervention vs control group) was conducted, each group containing 30 patients. Patients consisted of children with cancer aged 2-18 years old who were consulted to palliative team. A two-way communication between a trained health worker and patients with or without their parents were conducted as the intervention (report by proxy or self-report). Interventions were given in 6 sessions (1 session every 2 weeks) focusing on problems solving education, symptoms management, self-care, communication, decision making, and long-term care plan assistance. In the first and twelfth week of the intervention, all patients were assessed with the Pediatric Quality of Life Inventory (PedsQLTM) questionnaire cancer module 3.0. Symptomps intensity were assessed by Edmonton Symptoms Assesment Score (ESAS). Emergency room admissions from the last 3 months were noted before patients were enrolled in the study. During the follow up period, ER admissions were recorded further. Data was analyzed using bivariate analysis, OR calculations were performed to see the effect of interventions on outcomes in this study. A significant difference of quality of life was found between the two groups with average total score in control group 62.39 and intervention group 81.63 (p<0.001). Most significant increased domains were pain, nausea, procedural anxiety, treatment anxiety, and worry. Intensity of sleep disturbance (p=0.003) and anorexia (p<0.001) were decreased significantly in intervention group. Emergency room admissions were reduced by 4.7 times in intervention group (OR 4.77, 95% CI 1.29-17.65; p=0.018)."

"Infeksi soil-transmitted helminth (STH) merupakan salah satu permasalahan kesehatan utama di dunia, terutama di negara berkembang. Keberadaan dan aktivitas STH di tubuh inang dapat menyebabkan perubahan pada mukosa usus, termasuk menyebabkan kerusakan sel yang dapat mempengaruhi permeabilitas usus dan menstimulasi respon imun seperti inflamasi. Studi ini dilakukan untuk menentukan status inflamasi dan permeabilitas usus pada berbagai status infeksi parasit cacing usus pada anak usia balita di Kecamatan Nangapanda, Kabupaten Ende, Nusa Tenggara Timur. Sampel tinja yang diperoleh dari anak berusia 20-59 bulan diperiksa keberadaan telur cacing dengan metode Kato-Katz dan diukur konsentrasi biomarker permeabilitas dan inflamasi usus dengan metode Enzyme-linked immunosorbent assay. Biomarker permeabilitas usus yang digunakan adalah α-1-antitripsin (AAT) fekal sedangkan biomarker inflamasi usus yang digunakan adalah calprotektin fekal (FC). Prevalensi infeksi STH pada penelitian ini adalah 17,12%, dengan spesies dominan A. lumbricoides diikuti oleh T. trichiura. Sebagian besar anak memiliki AAT terdeteksi (64,71%), sedangkan hasil sebaliknya ditemukan untuk FC (35,06%). Status infeksi STH tidak memiliki hubungan yang signifikan dengan status konsentrasi AAT, termasuk ketika dianalisis dengan spesies STH. Hubungan yang signifikan hanya ditemukan antara infeksi T. trichiura dan status konsentrasi FC. Sebagian besar anak mengalami peningkatan permeabilitas usus, tetapi tidak selalu disertai inflamasi usus. Infeksi STH tidak memiliki hubungan yang signifikan dengan biomarker tinja kecuali antara status infeksi T. trichiura dan biomarker inflamasi usus yang mungkin dapat dijelaskan oleh perilaku spesies ini pada habitatnya dalam tubuh inang.

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Soil-transmitted helminth (STH) infection is still a major health problem in low-and middle-income countries (LMIC). The presence and activity of STH can cause changes in the intestinal mucosa, including cell damage that can affect intestinal permeability and stimulate immune responses such as inflammation. This study investigated the inflammatory and permeability status of the intestinal mucosa in various status of STH infection in preschool-age children (PSC) residing in Nangapanda District, Ende Regency, East Nusa Tenggara. Stool samples were obtained from children aged 20-59 months, and were then examined for worm eggs using Kato-Katz method and measured for the concentrations of biomarkers of intestinal permeability and inflammation by Enzyme-linked Immunosorbent assay. Intestinal permeability biomarkers were represented by fecal α-1-antitrypsin (AAT), while intestinal inflammation biomarkers were represented by fecal calprotectin (FC). The prevalence of STH infection in this study was 17.12%, with A. lumbricoides as the predominant species followed by T. trichiura. Most children had detectable AAT (64,71%), while the opposite result was found for FC (35,06%). STH infection status did not have a significant association with AAT concentration status, including when analyzed by STH species. A significant association was only found between T. trichiura infection and FC concentration status. Most children had increased gut permeability, but not necessarily accompanied by gut inflammation. STH infection did not have a significant correlation with fecal biomarkers except between T. trichiura infection status and gut inflammatory biomarker, which might be explained by the feeding habit of this spesies."

"Latar Belakang. Dermatitis atopi merupakan manifestasi penyakit alergi yang sering pada anak. Prevalens dermatitis atopi (DA) meningkat di seluruh dunia dengan awitan tersering pada usia 1 tahun pertama. Lesi DA cenderung relaps hingga usia 5 tahun, diikuti allergic march yang dapat menetap hingga dewasa. Beberapa faktor risiko DA ialah riwayat atopi keluarga, pajanan dini alergen, defek barier kulit dan berkurangnya kekerapan infeksi. Alergen yang sering mencetuskan DA berasal dari makanan. Peran ASI dalam mencegah DA dilaporkan dalam banyak studi, namun masih kontroversi. Studi mengenai hal ini belum banyak dilakukan di Indonesia.Tujuan. Mengetahui manfaat pemberian ASI eksklusif dalam mencegah kejadian DA pada anak.Metode. Desain penelitian ini ialah kasus-kontrol berpasangan dengan matching terhadap kelompok usia dan adanya riwayat atopi keluarga. Penelitian dilakukan pada anak berusia 7-24 bulan di Poliklinik Ilmu Kesehatan Anak dua Rumah Sakit swasta dan di sebuah Posyandu di Jakarta, pada bulan Juli-Desember 2012. Diagnosis DA ditegakkan pada kelompok kasus dengan kriteria Hanifin-Rajka.Hasil. Sebanyak 108 anak ikut serta dalam penelitian. Sebagian besar anak dengan DA berusia 7-24 bulan dan memiliki riwayat atopi keluarga. Awitan DA tersering pada usia 6 bulan pertama dengan predileksi lesi di wajah. Tidak terdapat perbedaan pola dan lama menyusui pada kelompok anak dengan dan tanpa DA. Manfaat ASI dalam mencegah DA pada anak pada penelitian ini belum dapat dibuktikan (RO 0,867;IK95% 0,512-2,635; p 0,851).Simpulan. Penelitian ini belum dapat membuktikan manfaat pemberian ASI eksklusif untuk mencegah kejadian DA pada anak. Pemberian ASI eksklusif masih sangat direkomendasikan karena memiliki banyak manfaat dan keunggulan dibandingkan susu formula.

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Latar Belakang. Dermatitis atopi merupakan manifestasi penyakit alergi yang sering pada anak. Prevalens dermatitis atopi (DA) meningkat di seluruh dunia dengan awitan tersering pada usia 1 tahun pertama. Lesi DA cenderung relaps hingga usia 5 tahun, diikuti allergic march yang dapat menetap hingga dewasa. Beberapa faktor risiko DA ialah riwayat atopi keluarga, pajanan dini alergen, defek barier kulit dan berkurangnya kekerapan infeksi. Alergen yang sering mencetuskan DA berasal dari makanan. Peran ASI dalam mencegah DA dilaporkan dalam banyak studi, namun masih kontroversi. Studi mengenai hal ini belum banyak dilakukan di Indonesia.

Tujuan. Mengetahui manfaat pemberian ASI eksklusif dalam mencegah kejadian DA pada anak.

Metode. Desain penelitian ini ialah kasus-kontrol berpasangan dengan matching terhadap kelompok usia dan adanya riwayat atopi keluarga. Penelitian dilakukan pada anak berusia 7-24 bulan di Poliklinik Ilmu Kesehatan Anak dua Rumah Sakit swasta dan di sebuah Posyandu di Jakarta, pada bulan Juli-Desember 2012. Diagnosis DA ditegakkan pada kelompok kasus dengan kriteria Hanifin-Rajka.Hasil. Sebanyak 108 anak ikut serta dalam penelitian. Sebagian besar anak dengan DA berusia 7-24 bulan dan memiliki riwayat atopi keluarga. Awitan DA tersering pada usia 6 bulan pertama dengan predileksi lesi di wajah. Tidak terdapat perbedaan pola dan lama menyusui pada kelompok anak dengan dan tanpa DA. Manfaat ASI dalam mencegah DA pada anak pada penelitian ini belum dapat dibuktikan (RO 0,867;IK95% 0,512-2,635; p 0,851).

Simpulan. Penelitian ini belum dapat membuktikan manfaat pemberian ASI eksklusif untuk mencegah kejadian DA pada anak. Pemberian ASI eksklusif masih sangat direkomendasikan karena memiliki banyak manfaat dan keunggulan dibandingkan susu formula."

"Latar belakang: Chemotheraphy induced nausea and vomiting (CINV) merupakan efek samping kemoterapi yang dapat menurunkan kualitas hidup dan kepatuhan pengobatan. Emetogenisitas kemoterapi merupakan prediktor utama terjadinya CINV. Di samping itu terdapat faktor risiko lain yang berperan terhadap kejadian CINV. Pada pasien kanker anak yang menjalani kemoterapi, sistem skoring berdasarkan faktor risiko diperlukan untuk mengklasifikasikan individu berisiko agar mendapatkan profilaksis antiemetik yang adekuat untuk mengontrol terjadinya CINV.Metode: Penelitian ini merupakan studi kohort prospektif yang bertujuan untuk mngembangkan sistem skoring dari faktor risiko CINV pada anak berusia 0-17 tahun yang menjalani kemoterapi di RSCM pada Desember 2023 – Maret 2024. Analisis bivariat dilanjutkan multivariat dilakukan untuk menentukan faktor risiko utama CINV akut, delayed dan CINV derajat ≥ 2 menurut skor common terminology criteria for adverse events (CTCAE) National Cancer Institute. Selanjutnya dilakukan pembobotan skor dari faktor risiko utama CINV derajat ≥ 2 dengan regresi logistik. Akurasi sistem skoring dilakukan dengan analisis kurva receiver-operating characteristic (ROC).Hasil: Sebanyak 198 subjek. Secara keseluruhan CINV terjadi pada 42,93% pasien dengan 32,3% subjek mengalami CINV derajat ≥ 2. CINV akut dan delayed dialami oleh masing-masing 26.77% dan 35,35% pasien. Berdasarkan analisis multivariat faktor risiko utama terjadinya CINV derajat ≥ 2 adalah riwayat mual/ muntah pada siklus kemoterapi sebelumnya, mendapatkan kemoterapi sisplatin dan terapi opioid. Analisis ROC menunjukkan akurasi yang cukup baik untuk memprediksi luaran dengan area under-the-curve (AUC) 0,669, p=0,034 IK 95% (0,602 – 0,736). Pasien dengan skor total 3-4 sebelum siklus kemoterapi diberikan, diklasifikasikan sebagai risiko tinggi untuk mengalami CINV derajat ≥ 2.Simpulan: Sistem skoring ini dapat digunakan dalam praktek klinis untuk memprediksi risiko CINV sebagai dasar pemberian profilaksis antiemetik yang adekuat

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Introduction: Chemotherapy-induced nausea and vomiting (CINV) are significant adverse effects of chemotherapy that can negatively impact quality of life and treatment adherence. The emetogenicity of chemotherapy is the main predictor of CINV. Apart from that, there are other risk factors that play a role in the incidence of CINV. In pediatric oncology patients undergoing chemotherapy, a risk factor-based scoring system is essential to identify high-risk individuals. This classification enables the administration of appropriate antiemetic prophylaxis to effectively manage and control CINV.

Methods: This research is a prospective cohort study conducted to develop risk scoring system for CINV on children aged 0-17 years undergoing chemotherapy at dr. Cipto Mangunkusumo Hospital (RSCM) from December 2023 to March 2024. Bivariate followed by multivariate analysis was performed to identify the main risk factors for acute, delayed and ≥ grade 2 CINV according to common terminology criteria for adverse events (CTCAE) scores National Cancer Institute. Subsequently, a scoring weight for the main risk factors of CINV grade ≥ 2 was determined using logistic regression. The accuracy of the scoring system was evaluated using receiver-operating characteristic (ROC) curve analysis.

Results: A total of 198 subjects were included in the study. Overall CINV occurred in 42.93% of patients with 32.3% of subjects experiencing CINV grade ≥ 2. Acute CINV and delayed CINV were experienced by 26.77% and 35.35% of patients, respectively. Multivariate analysis identified the main risk factors for CINV of grade ≥ 2 as a history of nausea/vomiting in previous chemotherapy cycles, receiving cisplatin chemotherapy, and opioid therapy. ROC analysis indicated a moderately good accuracy for predicting outcomes with an area under-the-curve (AUC) of 0.669, p = 0.034, 95% CI (0.602 – 0.736). Patients with a total score of 3-4 before each cycle of chemotherapy would be considered at high risk for developing ≥ 2 grade CINV.

Conclusion: This scoring system can be implemented in cli"

"Latar belakang: Prevalens obesitas pada anak dan remaja di seluruh dunia meningkat secara dramatis. Obesitas pada anak menjadi masalah karena merupakan predisposisi terjadinya obesitas saat dewasa yang berhubungan dengan timbulnya penyakit komorbiditas metabolik. Obesitas ditandai dengan penimbunan jaringan adiposa tubuh secara berlebihan, dan jaringan adiposa tersebut 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 (IL-6) dan protein fase akut (CRP dan AGP).Metode: Penelitian deskriptif potong lintang yang dilakukan pada siswa SD yang obes dan non-obes usia 9-12 tahun di Jakarta Selatan yang diizinkan oleh orangtua untuk mengikuti penelitian ini dan bersedia diukur antropometri serta diperiksa laboratorium Interleukin-6 (IL-6), C-reactive protein (CRP), dan alpha-1-acid glycoprotein (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 dengan nilai 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 dengan nilai 2,25 (0,4-64) vs 0,2 (<0,2- 2,6) dan kadar rerata AGP kelompok obes lebih tinggi dibandingkan kelompok non-obes dengan nilai rerata 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 lebih tinggi pada anak obes dibandingkan anak non- obes, kadar protein fase akut CRP lebih tinggi pada anak obes dibandingkan anak non-obes, dan kadar penanda AGP lebih tinggi pada anak obes dibandingkan anak non-obes.

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Background: Prevalence of obesity in children and adolescence is dramatically increasing. Obesity in children is an important predisposing factor of adult obesity and correlates with metabolic comorbidities. 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 (Interleukine 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, and AGP were taken from all subjects.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."

"Latar belakang. Translokasi bakteri dari saluran cerna merupakan masalah yang penting dalam terjadinya infeksi pada pasien dengan kolestasis obstruktif serta sirosis hepatis. Pada studi ini kami bermaksud untuk mempelajari komposisi mikrobiota usus dihubungkan dengan malabsorpsi lemak dan gangguan integritas usus pada anak dengan kolestasis kronis. Metode. Sampel feses dari bayi/anak dengan kolestasis dan anak sehat dikumpulkan untuk dilakukan evaluasi terhadap jumlah sel lemak, komposisi mikrobiota usus serta integritas ususnya. Hasil. Lima puluh tujuh bayi/anak (27 kolestasis dan 30 anak sehat) dilakukan evaluasi. Terdapat perbedaan bermakna pada berat badan, P=0.001; status nutrisi, P=<0.0001; serta konsumsi susu formula dengan bahan dasar middle chain triglyceride, P=<0.0001. Selain itu juga ditemukan bahwa komposisi lemak pada feses serta kadar fecal calprotectin lebih tinggi pada kelompok kolestasis dibandingkan dengan anak sehat, P=<0.0001 dan P=0.021. Sesuai dengan hasil tersebut ditemukan pula perbedaan yang bermakna di antara kedua grup tersebut pada komposisi Bifidobacteria sp. and E. Coli sp., P=0.005. Kesimpulan. Ditemukan perbedaan yang bermakna pada berat badan, status nutrisi, komposisi lemak feses, kadar fecal calprotectin serta profil mikrobiota usus antara kelompok bayi dengan kolestasis dengan bayi sehat. Diperlukan studi lanjutan untuk mempelajari interaksi antara saluran cerna dan hati pada kolestasis.

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Background. Bacterial translocation from the gastrointestinal tract is central to current concepts of endogenous sepsis in obstructif cholestasis and cirrhosis. In this study we evaluate gut microbiota profile and their correlation with fat malabsorption and gut integrity. Methods. We evaluate feces sampels from chronic cholestasis and healthy infants to know their fat malabsorption, gut microbiota composition, and gut integrity, then compare between the 2 groups.

Results. Fifty-seven infants (27 cholestasis and 30 healthy) were evaluated. There were significant difference in mean body weight 7932.39 (SD: 3416.2) VS 11453.3 (SD: 4012.3) grams, P=0.001; nutritional status, P=<0.0001, and middle chain triglyceride dominant infant formula, P=<0.0001. Feces evaluation showed a significant hinger fat composition (+2 and +3), P=<0.0001 and fecal calprotection level in cholestatic groups (81.32 (SD:61.6) VS 47.37 (SD:47.3) microgram/g faeces), P=0.021. In accordance with fecal calprotectin level, there were a significant difference between the 2 groups in composition of Bifidobacteria sp. and E. Coli sp., P = 0.005.

Conclusions. Significant differences were found in body weight, nutritional status, feces fat composition, fecal calprotection level and gut microbiota profile between chronic cholestasis and healthy infants. Further studies needed to evaluate the interaction between gut and liver axis in infants with cholestasis."

"[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.]"