Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
ABSTRAK
Latar belakang: Diare masih merupakan masalah kesehatan masyarakat di negara berkembang karena morbiditas dan mortalitasnya yang masih tinggi. Diare dapat disebabkan oleh virus, bakteri dan parasit yang penting diketahui untuk memberikan tatalaksana yang tepat, namun saat ini belum ada data mengenai bakteri penyebab diare di Indonesia. Tujuan: Mengetahui gambaran klinis anak dengan diare akut dan mengetahui jenis bakteri enteropatogen penyebab diare akut dengan menggunakan real-time PCR di Rumah Sakit Cipto Mangunkusumo. Metode: Penelitian potong lintang pada anak dengan diare akut berusia 1-15 tahun di Rumah Sakit Cipto Mangunkusumo. Hasil: Subyek penelitian ini terdiri dari 60 subyek dengan diare akut. Sebagian besar berusia 1-3 tahun, status gizi baik, berasal dari ibu dengan pendidikan sedang dengan status ekonomi keluarga menengah rendah, sebagian besar belum mendapat antibiotik sebelum ke rumah sakit tetapi sudah mendapat cairan rehidrasi oral. Gambaran klinis diare akut akibat infeksi bakteri yaitu frekuensi diare ≤5X/hari (p=0,018), tanpa leukositosis feses (p=0,015) dan malabsorpsi lemak (p=0,031). Sebaran infeksi bakteri patogen penyebab diare akut berdasarkan real-time PCR sebagai berikut: Campylobacter jejuni 7 subyek, Escherichia coli patogen 17 subyek yang terdiri dari EPEC 9 subyek, EIEC 5 subyek dan ETEC 3 subyek. Infeksi bakteri campuran pada subyek sebagai berikut: EPEC+EIEC 2 subyek , C.jejuni+EPEC 1 subyek, C.jejuni+EPEC+EIEC 1 subyek dan C.jejuni+EPEC+ETEC 1 subyek. Simpulan: Sebagian besar diare terjadi pada usia 1-3 tahun dengan status pasien gizi baik dengan status keluarga menengah rendah. Sekitar 48% anak dengan diare akut didapatkan bakteri dari hasil real-time PCR feses dengan proporsi terbanyak yaitu EPEC, diikuti Campylobacter jejuni, EIEC dan ETEC. ABSTRACT
Background: Diarrhea is still a public health problem in developing countries due to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteria and parasites. It is important to know the etiology to provide proper management, but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acute diarrhea and determine the type of enteropathogens bacteria causing acute diarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stool specimens were collected from patients aged 1-15 years with acute diarrhea and tested for bacterial enteropathogens using real-time PCR. Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritional status, from low income families and secondary education mothers, most have not received antibiotics prior to hospital admission but had received oral rehydration fluids. The clinical features of acute diarrhea caused by bacterial infection is diarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption. From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved by real-time PCR. Distribution of pathogenic bacterial infection causes acute diarrhea by real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenic Escherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjects and ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2 subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject and C.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCR stool with the highest proportion is EPEC, followed by Campylobacter jejuni, EIEC and ETEC. ;Background: Diarrhea is still a public health problem in developing countries due to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteria and parasites. It is important to know the etiology to provide proper management, but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acute diarrhea and determine the type of enteropathogens bacteria causing acute diarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stool specimens were collected from patients aged 1-15 years with acute diarrhea and tested for bacterial enteropathogens using real-time PCR. Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritional status, from low income families and secondary education mothers, most have not received antibiotics prior to hospital admission but had received oral rehydration fluids. The clinical features of acute diarrhea caused by bacterial infection is diarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption. From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved by real-time PCR. Distribution of pathogenic bacterial infection causes acute diarrhea by real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenic Escherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjects and ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2 subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject and C.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCR stool with the highest proportion is EPEC, followed by Campylobacter jejuni, EIEC and ETEC. ;Background: Diarrhea is still a public health problem in developing countries due to it?s morbidity and mortality. Diarrhea can be caused by viruses, bacteria and parasites. It is important to know the etiology to provide proper management, but there is currently no data on the bacteria that causes diarrhea in Indonesia. Objective: To characterize the clinical manifestations of children with acute diarrhea and determine the type of enteropathogens bacteria causing acute diarrhea using real-time PCR in Cipto Mangunkusumo Hospital. Methods: This was a cross-sectional study, done in June-November 2015. Stool specimens were collected from patients aged 1-15 years with acute diarrhea and tested for bacterial enteropathogens using real-time PCR. Results: Of the 60 children enrolled, mostly aged 1-3 years, good nutritional status, from low income families and secondary education mothers, most have not received antibiotics prior to hospital admission but had received oral rehydration fluids. The clinical features of acute diarrhea caused by bacterial infection is diarrhea frequency ≤5X / day without fecal leukocytosis and fat malabsorption. From 60 subjects, 29 (48,3%) children excreted bacteria in their feces prooved by real-time PCR. Distribution of pathogenic bacterial infection causes acute diarrhea by real-time PCR as follows: Campylobacter jejuni 7 subjects, pathogenic Escherichia coli 17 subjects which consists of EPEC 9 subjects, EIEC 5 subjects and ETEC 3 subjects. Multiple infections in subjects as follows: EPEC+EIEC 2 subjects, EPEC+C.jejuni 1 subject, C.jejuni+EPEC+EIEC 1 subject and C.jejuni+EPEC+ETEC 1 subject. Conclusions: Most diarrhea occurs at the age of 1-3 years with good nutritional status of patients with low-medium family status. Approximately 48% of children with acute diarrhea excreted bacteria in their feces prooved by real-time PCR stool with the highest proportion is EPEC, followed by Campylobacter jejuni, EIEC and ETEC.

Abstrak :
Latar Belakang: Epilepsi di negara berkembang dua kali lebih tinggi dibandingkan negara maju. Sekitar 60-70% pasien bebas kejang dengan obat antiepilepsi (OAE) generasi satu, jika tidak respons dan kejang menetap maka dipertimbangkan OAE generasi dua. Keberhasilan pengobatan epilepsi dipengaruhi oleh pelbagai faktor serta bergantung terhadap plastisitas dan maturitas otak hingga usia tiga tahun. Belum ada penelitian yang menilai faktor-faktor keberhasilan terapi OAE generasi dua. Tujuan: Mengetahui faktor risiko keberhasilan keberhasilan terapi OAE generasi 2 pada pasien epilepsi anak usia di bawah tiga tahun. Metode: Studi kasus kontrol dengan data sekunder berupa rekam medis. Sampel penelitian adalah anak epilepsi berusia di bawah tiga tahun yang mendapatkan minimal salah satu OAE generasi 2 berupa topiramat/levetiracetam/lamotrigin. Subyek terbagi kelompok kontrol (dilakukan matching usia) yang kejangnya tidak terkontrol dan kelompok kasus yang kejangnya terkontrol minimal enam bulan. Faktor risiko yang diteliti adalah tipe kejang, status perkembangan, status neurologis awal, gambaran elektroensefalografi (EEG) awal, evolusi klinis dan evolusi EEG. Hasil: Didapatkan 60 subyek pada masing-masing kelompok; pada kelompok kasus paling banyak dijumpai 66,7% laki-laki, 31,7% rentang usia 6-12 bulan, 83,3% usia awitan kejang <12 bulan, dan 93,3% tipe kejang umum. Dari 6 faktor risiko yang diteliti, hanya evolusi EEG berperan independen dalam memengaruhi keberhasilan terapi, nilai p<0,001; aOR 9,53; IK95% 3,39-26,77. Kesimpulan: Pasien dengan evolusi EEG baik memiliki kemungkinan sebesar 9,53 kali lipat lebih besar untuk kerjangnya terkontrol dengan OAE generasi 2, dibandingkan pasien dengan evolusi EEG buruk.

---

Background: Epilepsy in developing countries is twice compared developed countries. About 60-70% epilepsy patients had seizure-free with first generation antiepileptic drugs (AED), if there is no response and persistent seizures, second generation AED is considered. The success of epilepsy treatment is influenced by various factors and depends on the plasticity and maturity of the brain until the first 3 years. There are no studies that assess the success factors of second generation OAE therapy. Purpose: To assess the risk factors that affecting the success of second generation therapy in children under 3 years old with epilepsy. Methods: A case control study with secondary data from medical records. The study sample was children under 3 years old with epilepsy who received at least one of second generation AED (topiramate/levetiracetam/lamotrigine). Subjects were divide into 2 groups, control groups (age matching) whose seizure were not controlled and case groups whose seizure were controlled for at least six months. The risk factors studied were seizure type, developmental status, initial neurological status, initial electroencephalography (EEG), clinical evolution and EEG evolution, Results: There were 60 subjects in each group; the most proportion in case group were 66,7% males, 31,7% of the age range of 6-12 months, 83,3% onset of seizures <12 months, and 93,3% general seizures. Of the 6 risk factors studied, only the EEG evolution significantly and independently affecting the success of therapy, with p value <0,001; aOR 9.53; 95%CI 3.39-26.77. Conclusion: Patients with good EEG evolution were 9.53 times more likely to have controlled seizure with second generation AED, compared to patients with poor EEG evolution.

Abstrak :
ABSTRACT
Pasien anak dengan keganasan dapat mengalami episode demam neutropenia. Etiologi bakterimia pada demam neutropenia berbeda-beda pada tiap pusat pelayan kesehatan dan berubah secara periodik. Antibiotik empiris diberikan pada pasien demam neutropenia berdasarkan klasifikasinya. Skor Rondinelli mengklasifikasikan pasien demam neutropenia menjadi risiko rendah dan risiko tinggi. Luaran dengan menggunakan skor Rondinelli belum pernah dilaporkan.

Tujuan : Mengetahui karakteristik etiologi dan perjalanan klinis demam neutropenia pada anak dengan keganasan yang dirawat inap di Departemen Ilmu Kesehatan Anak RSCM.

Metode : Penelitian ini adalah deskriptif retrospektif. Sampel diambil dari data sekunder berupa rekam medis pasien anak dengan keganasan yang mengalami demam neutropenia yang menjalani rawat inap di bangsal Departemen IKA FKUI/RSCM mulai bulan Januari 2010 hingga bulan September 2013.

Hasil : Penelitian dilakukan pada 86 pasien anak yang mengalami 96 episode demam neutropenia yang memenuhi kriteria inklusi dan eksklusi. Prevalensi bakterimia pada episode demam neutropenia pada anak dengan keganasan adalah 17%. Proporsi kuman penyebab terbanyak bakterimia pada demam neutropenia adalah Staphylococcus sp (25%), Pseudomonas aeruginosa (25%), Klebsiella pneumonia (19%) dan Escherichia coli (13%). Penelitian ini mendapatkan luaran episode demam neutropenia pada anak dengan keganasan adalah 40% memiliki luaran sembuh, 49% memiliki luaran tidak sembuh dan 6% meninggal dunia. Berdasarkan skor Rondinelli didapatkan 30 (61%) episode demam neutropenia risiko rendah memiliki luaran sembuh dan hanya 13 (28%) episode demam neutropenia risiko tinggi yang memiliki luaran sembuh.

Simpulan : Sebagian besar hasil kultur darah pada demam neutropenia adalah steril. Kuman gram negatif penyebab terbanyak bakterimia pada demam neutropenia. Demam neutropenia memiliki morbiditas yang tinggi. Skor Rondinelli dapat digunakan untuk mengklasifikasikan demam neutropenia pada anak dengan keganasan.

---

ABSTRACT
Cancer children could have febrile neutropenia (FN) episodes. The bacteremia etiology of FN from each health center was different and periodically changed. Empirical antibiotic was given to the patient according to the classification. Rondinelli’s score classify FN patient to low risk and high risk. Outcome of Rondinelli’s score is not yet reported.

Purpose: To know the clinical pathway and characteristic of etiology FN in cancer children in Department of Child Health RSCM ward.

Methods: The retrospective descriptive study. Samples were taken from secondary data in medical report of a cancer child with FN in ward in Department of Child Health FKUI/RSCM from January 2010 to September 2013.

Results: There were 86 children with 96 FN episodes that fulfill the inclusion and exclusion criteria. Bacteremia prevalence in cancer child with FN episodes was 17%. The most frequent proportion bacteria as FN etiology were Staphylococcus sp (25%), Pseudomonas aeruginosa (25%), Klebsiella pneumoniae (19%), and Escherichia coli (13%). The outcome of cancer children with FN were 40% recover, 49% not recover, and 6% pass away. Rondinelli’s score outcome showed 30 (61%) episodes of low risk FN recover and only 13 (28%) episodes of high risk FN recover.

Conclusions: Most of blood culture result of FN was sterile. Gram negative bacteria were the most frequent etiology for FN. FN has high morbidity.

Abstrak :
Latar belakang. Pemakaian kotrimoksazol sedini mungkin sejak diberikan ARV bermanfaat mencegah infeksi oportunistik terkait HIV (PCP dan toksoplasmosis) dan mengurangi mortalitas terkait pasien HIV dengan jumlah CD4 rendah. Faktor risiko yang memengaruhi mortalitas pada anak terinfeksi HIV yang telah mendapat ARV perlu dicari sehingga dapat membantu klinisi dalam memberikan tata laksana pada anak terinfeksi HIV di Indonesia. Tujuan. Evaluasi pemakaian kotrimoksazol dan hubungannya terhadap mortalitas pada anak terinfeksi HIV yang telah mendapat ARV di RSCM pada tahun 2005-2018. Metode. Uji deskriptif-analitik menggunakan analisis kesintasan yang dilakukan secara kohort retrospektif di RS. Dr. Cipto Mangunkusumo (RSCM) menggunakan data rekam medis periode Januari 2005 - Desember 2018. Subyek adalah anak berusia 1 bulan-18 tahun yang mendapat ARV pertama kali di RSCM. Hubungan pemakaian kotrimoksazol dengan mortalitas dianalisis dengan uji log rank. Faktor-faktor risiko selanjutnya dianalisis secara multivariat. Hasil. Subjek dalam penelitian ini berjumlah 403. Proporsi pemakaian kotrimoksazol saat inisiasi ARV pada anak terinfeksi HIV adalah 88%. Tidak terdapat hubungan antara pemakaian kotrimoksazol saat inisiasi ARV dengan mortalitas (HR 1,498; IK 95% 0,620-3,618, p=0,369), namun pemakaian kotrimoksazol saat inisiasi ARV menurunkan mortalitas pada kondisi imunodefisiensi berat (HR 2,702; IK 95% (1,036-7,049); p=0,042). Faktor risiko yang memengaruhi mortalitas pada anak terinfeksi HIV yang mendapat terapi ARV adalah stadium HIV (stadium 3-4). Kesimpulan. Pemakaian kotrimoksazol saat inisiasi ARV menurunkan mortalitas pada anak terinfeksi HIV dengan imunodefisiensi berat. Faktor risiko yang memengaruhi mortalitas pada anak terinfeksi HIV yang telah mendapat ARV adalah stadium HIV 3-4. ......Background. The use of cotrimoxazole as early as possible since being administered antiretroviral drugs is beneficial in preventing HIV-related opportunistic infections (PCP and toxoplasmosis) and reducing mortality associated with HIV patients with low CD4 counts. Risk factors that affect mortality in HIV-infected children who have received antiretroviral drugs need to be sought so that they can help clinicians in providing HIV-infected children in Indonesia. Objective. Evaluation of the use of cotrimoxazole and its association with mortality in HIV-infected children who had received ARV at RSCM in 2005-2018. Methods. Descriptive analytic test using survival analysis were carried out in a retrospective cohort in Dr. Cipto Mangunkusumo hospital using medical record data for the period January 2005 - December 2018. Subjects were children aged 1 month - 18 years who have received ARV for the first time at RSCM. The association of cotrimoxazole use with mortality was analyzed by log rank test. Risk factors are then analyzed multivariately. Results. This study involved 403 subjects. The proportion of cotrimoxazole use at ARV initiation in HIV-infected children was 88%. There was no association between the use of cotrimoxazole at ARV initiation and mortality (HR 1.498; 95% CI 0.620-3.618; p=0,369), but the use of cotrimoxazole at ARV initiation reduced mortality in severe immunodeficiency conditions (HR 2.702; 95% CI 1,036-7,049; p=0.042). Risk factors that affect mortality in HIV-infected children who received ARV therapy are stages of HIV (stage 3-4). Conclusion. The use of cotrimoxazole at ARV initiation reduces mortality in HIV-infected with severe immunodeficiency. Risk factors that affect mortality in HIV-infected children who have received ARV are stage 3-4.

Abstrak :
Latar belakang: Kejadian penyakit ginjal kronik (PGK) pada anak berkembang dengan cepat menuju penyakit ginjal tahap akhir (PGTA), yang sering disertai gejala saluran cerna termasuk infeksi Helicobacter pylori (H. pylori). Faktor risiko infeksi H. pylori pada anak PGTA yang menjalani dialisis termasuk status nutrisi, status sosioekonomi, kepadatan lingkungan, tipe dan durasi dialisis. Tujuan: Mengidentifikasi faktor risiko infeksi H. pylori pada anak dengan PGTA yang menjalani dialisis. Metode: Penelitian cross-sectional ini menganalisis data primer pasien anak dengan PGTA yang menjalani dialisis di RSUPN Cipto Mangunkusumo (RSCM) Kiara pada tahun 2023. Hasil: Jumlah subyek penelitian ini adalah 47 anak yang terdiri dari 30 (63,8%) lelaki dan 17 (36,2%) perempuan. Nilai rerata usia adalah 13,15 ± 2,72 tahun. Mayoritas pasien tinggal pada pedesaan (57,4%), menjalani hemodialisis (70,2%) dengan durasi dialisis ≥1 tahun (55,3%), mengalami malnutrisi (51,1%) dengan status sosioekonomi rendah (61,7%), crowding index (CRI) >2 (66%), terinfeksi H. pylori (80,9%), memiliki skor frequency scale for the symptoms of GERD (FSSG) ≥8 (61,7%) dan skor pediatric quality of life inventory (PedsQL) <70 (97,9%). Berdasarkan analisis multivariat, faktor risiko yang berhubungan dengan infeksi H. pylori pada pasien anak dengan PGTA adalah kepadatan lingkungan (p=0,012) dan status sosioekonomi (p=0,048). Kesimpulan: Prevalens infeksi H. pylori pada anak dengan PGTA yang menjalani dialisis adalah sebesar 80,9% dengan reratan usia pasien 13.15 ± 2,72 tahun. Dari hasil analisis multivariat, faktor risiko infeksi H.pylori adalah kepadatan lingkungan (p=0,012) dan status sosioekonomi (p=0,048). Mayoritas pasien memiliki kualitas hidup yang terganggu. ......Background: The incidence of chronic kidney disease (CKD) in children increases rapidly towards end stage renal disease (ESRD) which is often accompanied with gastrointestinal symptoms include Helicobacter pylori (H. pylori) infection. Risk factors for H. pylori infection in ESRD children undergoing dyalisis include poor nutritional and low socioeconomic status, crowded environments, type and duration of dialysis. Objective: To identify risk factors of H. pylori infection in pediatric ESRD patients undergoing dialysis. Methods: This cross-sectional study analyzed primary data on pediatric ESRD patients undergoing dialysis at Dr. Cipto Mangunkusumo National Central Public Hospital in 2023. Results: The number of subjects in this study were 47 children, 30 (63.8%) boys and 17 (36.2%) girls. The mean value for age was 13.15 ± 2,72 years. Most patients lived in rural areas (57.4%), had hemodialysis (70.2%) with duration of ≥1 year (55.3%), had malnutrition (51.1%), with low socioeconomic status (61.7%), crowding index (CRI) >2 (66%), infected by H. pylori (80.9%), had frequency scale for the symptoms of GERD (FSSG) score of ≥8 (61.7%) and pediatric quality of life inventory (PedsQL) score <70 (97.9%). Based on multivariate analysis, the risk factors associated with H. pylori infection in pediatric ESRD patients were environmental density (p=0,012) and socioeconomic status (p=0,048). Conclusion: Prevalence of pediatric ESRD patients who had dialysis that were infected by H. pylori was 80.9% and the age’s average value was 13.15 ± 2,72 years. Based on multivariate analysis, the risk factors for H. pylori infection were environmental density (p=0,012) and socioeconomic status (p=0,048). Most of the patients had low quality of life.