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"ABSTRAKLatar Belakang. Biomarker dapat digunakan untuk memprediksi derajat keparahan trauma kepala.Tujuan. Mengetahui hubungan antara kadar S100B dengan derajat keparahan trauma kepala dan kelainan CT scan kepala.Metode Penelitian. Penelitian potong lintang di IGD RSUPN Cipto Mangunkusumo, RSUP Fatmawati, dan RS Permata Cibubur selama Juli-Desember 2015. Subjek adalah anak usia 1-18 tahun yang mengalami trauma kepala dengan onset <24 jam. Setiap subjek dilakukan pemeriksaan skor Skala Koma Glasgow Pediatrik, pemeriksaan CT scan kepala bila terdapat indikasi, serta pemeriksaan kadar S100B dari serum.Hasil Penelitian. Subjek penelitian terdiri atas 20 subjek trauma kepala ringan dan 18 subjek trauma kepala sedang. Hasil penelitian menunjukkan terdapat perbedaan bermakna kadar S100B kelompok trauma trauma kepala sedang dan kepala ringan; median (rentang) 0,173 (0,054-0,812) μg/L dibandingkan 0,067 (0,039-0,084) μg/L, p<0,001. Selain itu juga terdapat perbedaan bermakna antara kelompok yang terdapat kelainan CT scan kepala dibandingkan dengan yang tidak ada kelainan; 0,124 (0,051-0,812) μg/L dan 0,067 (0,039-0,084) μg/L, p=0,001. Berdasarkan analisis ROC, kadar S100B serum sangat kuat untuk memprediksi trauma kepala sedang (AUC 0,818, p=0,001 dan IK95% 0,668-0,969) dengan nilai cut-off 0,083 μg/L.Simpulan. Kadar S100B serum pada trauma kepala sedang secara bermakna lebih tinggi dari trauma kepala ringan serta memiliki kemampuan diskriminasi sangat baik untuk memprediksi derajat keparahannya.

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ABSTRACT

Background. Biomarker has ability to predict the severity of TBI and abnormal CT scan.

Objectives. To determine the association between S100B level with the severity of pediatric TBI and intracranial injury.

Methods. A cross-sectional study at Emergency Department of RSUPN Cipto Mangunkusumo, RSUP Fatmawati, and Permata Cibubur Hospital on July- December 2015. Subjects were 1-18 year-old children with TBI, onset within 24 hours before admission. We measured Pediatric GCS score, serum S100B level, and performed cranial CT scan if indicated.

Results. Twenty subjects had mild TBI and 18 subjects had moderate TBI were included. S100B levels were higher in children with moderate TBI as compared to children with mild TBI; 0,173 (0,054-0,812) μg/L vs 0,067 (0,039-0,084) μg/L, p<0,001. S100B levels were significantly elevated in children following TBI with abnormal cranial CT scan as compared to children with a normal CT scan (0,124 (0,051-0,812) μg/L vs 0,067 (0,039-0,084) μg/L, p=0,001). AUC for S100B was also significant (0,818, p=0,001, CI95% 0,668-0,969) as prediction of moderate TBI with cut-off point 0,083 μg/L.

Conclusions. Children with moderate TBI had significantly higher S100B levels as compared to children with mild TBI. Cut-off point S100B level at 0,083 μg/L has good ability to predict the severity of TBI."

"Pediatric homicide investigations are often clouded by a number of factors, not the least of which is a lack of straightforward resources. Designed for quick access, this volume provides an invaluable resource for medical examiners, police, child abuse investigators, and attorneys. Focusing on forensic pathology aspects, this book covers all typical causes of death, including asphyxiation, intentional drowning, abdominal trauma, head injury, poisoning, and intentional starvation. Each of the chapters considers medical and investigative difficulties associated with that particular cause, includes illustrative photographs, and provides the means to confirm the diagnosis."

"Cedera merupakan penyebab utama kematian pada anak prasekolah, anak usia sekolah, dan remaja di seluruh dunia. Penelitian tentang cedera ini bertujuan mengetahui gambaran pengetahuan dan sikap anak usia sekolah terhadap upaya pencegahan cedera pada 107 responden anak usia sekolah di MIT Fatahillah Cimanggis, Depok. Jenis penelitian yaitu kuantitatif deskriptif dengan desain penelitian cross sectional. Pengambilan sampel dilakukan dengan teknik purposive non random sampling. Hasil penelitian ini menunjukkan responden memiliki pengetahuan yang tinggi dan sikap yang positif terhadap upaya pencegahan cedera. Pendidikan tentang pencegahan cedera penting diberikan sejak anak usia dini agar dapat menurunkan angka kejadian cedera pada anak usia sekolah.

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Injuries are the leading cause of death for preschool, school-age, and adolescent. This study aims to describe the level of knowledge and attitude of school age toward injury prevention. This research’s conducted towards 107 participants in MIT Fatahillah Cimanggis, Depok. Design of this study was a quantitative descriptive studies using cross sectional approach. The participants were recruited using purposive-sampling technique. Results demonstrated that the participants have high level of knowledge and positive attitude towards the injury prevention. Lesson about injury prevention is important for children since young to reduce a number of injuries in school age children."

"Cedera ditandai dengan terjadinya luka dan kerusakan pada tubuh disebabkan dari berbagi macam bentuk tindakan baik itu sengaja maupun tidak disengaja. Beberapa penelitian menunjukkan bahwa anak usia toddler sangat rentang terhadap cedera di dalam lingkungan rumah. Penelitian ini bertujuan mendeskripsikan perilaku pencegahan cedera pada orang tua yang memiliki anak usia toddler di dalam lingkungan rumah. Desain penelitian ini menggunakan deskriptif sederhana dengan pendekatan cross-sectional melibatkan orang tua dengan anak usia toddler di wilayah Kelurahan Mekarjaya Kota Depok sebanyak 92 responden yang dipilih dengan teknik consecutive sampling. Instrumen yang digunakan adalah kuesioner yang dikembangkan sendiri yaitu Kuesioner Perilaku Pencegahan Cedera. Hasil penelitian menunjukkan bahwa mayoritas responden masuk dalam rentang perilaku tidak berisiko yaitu sebesar 53,3%. Peneliti menyarankan untuk diadakannya edukasi mengenai cedera dan pencegahan cedera pada rentang usia anak terutama anak usia toddler untuk meningkatkan informasi dan pengetahuan masyarakat mengenai cedera dan pencegahan cedera.

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Injury is characterized by the occurrence of injury and damage to body from action either intentionally or unintentionally. Some research showed that toddler were very vulnerable to injury at home.

The purpose of this research is to describe the behavior of injury prevention in parents who had toddler in their home. The design of this research is using simple descriptive with cross-sectional approach. The respondents were 92 parents with toddler at Mekarjaya Depok and selected by consecutive sampling technique. The instrumen that used was a self-developed questionnaire called Injury Prevention Behaviors Questionnaire.

The results showed that the majority of parents were not in risk behavior (53,3%). The researcher suggests to give society an Education about injury prevention concerning the age range, especially toddler, to raise knowledge and information about injury and injury prevention."

" Fractures are a common finding in children and it is estimated that 2.1% of all children will suffer at least one fracture before the age of 16. With young children in particular, the question may arise if this is related to child abuse. The aim of this book is to help physicians involved in child abuse cases to interpret radiological findings in light of the forensic circumstances under which they occurred. The authors present up-to-date literature related to the mechanisms underlying non-accidental cases of trauma. In this book not only the radiological findings in child-abuse are discussed, but more importantly, these findings are analyzed from a forensic perspective. Careful attention is paid to evidence regarding reported trauma mechanisms and their clinical outcome; for example, can a fall from a couch result in a femoral fracture, and if not, where is the supporting evidence?"

"Latar Belakang: Cedera Otak Traumatik (COT) mempengaruhi jutaan orang di seluruh dunia setiap tahunnya. Penelitian ini bertujuan untuk mengetahui hubungan temuan radiologi TBI dengan angka kecacatan dan kematian di RSUPN dr. Cipto Mangunkusumo. Metode: Penelitian ini merupakan penelitian deskriptif analitis, dilakukan secara retrospektif dengan menggunakan data sekunder yang diambil dari rekam medis dan arsip pasien yang disediakan oleh Departemen Neurologi FKUI-RSCM yang telah didiagnosis menderita COT sedang dan berat di RSUPN dr. Cipto Mangunkusumo dari Januari hingga Desember 2021. Hasil CT diklasifikasikan menggunakan skor CT Rotterdam. GOSE digunakan sebagai outcome prediktor dimana penilaian dilakukan pada hari ke 14, 30, dan 90. Analisis bivariat akan dilakukan dengan menggunakan uji Chi-square dan uji Mann-Whitney. Hasil: TBI sedang menjadi dominan (88,5%) dan SAH menjadi kelainan CT paling umum di RSCM (57,6%). Usia ditemukan menjadi faktor signifikan dalam perkembangan hasil yang lebih buruk pada hari ke-14 pasca-trauma (p= 0,026). Keparahan juga ditemukan sebagai faktor yang signifikan terlepas dari kapan skor GOSE diambil (hari ke-14 p= 0,004, hari ke-30 p= <0,001, hari ke-90 p=<0,001). SAH merupakan prediktor hasil yang signifikan pada hari ke-14 (p=0,030), hari ke-30 (p=0,010), dan hari ke-90 (p = 0,009). DAI (p= 0,048) dan edema serebral (p=0,009) memainkan peran penting terhadap hasil pada hari ke-90. Skor CT Rotterdam memiliki hubungan yang signifikan terhadap prediksi hasil pada hari ke-14 (p=0,009), hari ke-30 (p <0,001), dan hari ke- 90 (p <0,001). Kesimpulan: Tingkat keparahan COT, SAH, DAI, dan edema serebral mempunyai peran penting dalam prediksi hasil akhir penelitian.

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Introduction: TBI affects millions of individuals around the world. This research aims to explore the relationship between radiological findings of TBI and the disability and mortality rate in Cipto Mangunkusumo Hospital Methods: This is a descriptive analytical research, done in a retrospective way by the usage of secondary data extracted from medical records of patients that had been diagnosed with TBI in Cipto Mangunkusumo hospital in 2021. GOSE was used as an outcome predictor in which assessment was done at the 14th, 30th, and 90th day. Analysis was done using Chi-square test and Mann-Whitney test Results: Moderate TBI to be predominant (88.5%) and SAH to be the most prevalent CT abnormality in Cipto Mangunkusumo hospital (57.6%). Age was found to be a significant factor in the development of worse outcomes in the 14th day post-trauma (p= 0.026). Severity was found to be a significant factor also regardless of when the GOSE score was taken (14th day p= 0.004, 30th day p= <0.001, 90th day p=<0.001). SAH was a significant predictor of outcome at the 14th day (p=0.030), 30th day (p=0.010), and 90th day (p = 0.009). DAI (p= 0.048) and cerebral edema (p=0.009) played a significant role on the outcome at the 90th day. Rotterdam CT score had a significant association in outcome prediction at the 14th day (p=0.009), 30th day (p < 0.001), and 90th day (p < 0.001). Conclusion: Severity, Rotterdam CT score, SAH, DAI, and cerebral edema had a significant role in prediction of outcome at the end of the study."