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"Latar Belakang: Infeksi Aliran Darah (IAD) terkait infeksi rumah sakit atau infeksi nosokomial telah menyebabkan beban kesakitan, kematian dan biaya yang cukup besar. Penelitian ini bertujuan untuk menilai kejadian infeksi Rumah Sakit-IAD pada neonatus dengan berat lahir 1000-2000 g yang dirawat di Unit Neonatal RSUPNCM, Jakarta, selama 4 bulan (Oktober 2010 - Januari 2011), dan melihat kemungkinan keterkaitan mikroba lingkungan dengan kejadian IAD di unit Neonatal. Metode: Subjek penelitian adalah neonatus (berat lahir 1000-2000 g) dengan klinis sepsis dan telah dirawat di rumah sakit selama minimal 48 jam, tidak ditemukan fokal infeksi yang jelas dan menggunakan kateter intra-vascular. Pada subjek penelitian dilakukan pemeriksaan biakan darah dengan dua spesimen darah yang diambil dari dua kali pengambilan darah. Biakan yang positif dilanjutkan dengan proses identifikasi dan uji sensitivitas terhadap antibiotika. Pemeriksaan biakan dari spesimen lingkungan unit perawatan dan spesimen klinis lainnya juga dilakukan. Hasil: Dari 29 neonatus dengan 39 episode sepsis, 5 biakan darah positif, dengan isolat: Enterobacter asburiae (2), Enterobacter cloacae (1), Pseudomonas aeruginosa (1) dan Klebsiella oxytoca (1). Infeksi rumah sakit-IAD yang terkonfirmasi dengan hasil laboratorium (laboratory confirmed) adalah 12,8% (5/39), sementara rate IAD adalah 1,46 per 1000 hari pemasangan kateter selama 4 bulan (Oktober 2010-Januari 2011). Spesies bakteri yang sama juga ditemukan dari lingkungan dan spesimen klinis lainnya. Analisis dari antibiogram masing-masing isolat dari darah dan lingkungan menunjukkan kemiripan dan pada beberapa strain identik yaitu strain E. asburiae, dan strain P. aeruginosa. Kesimpulan: Bakteri yang berperan sebagai penyebab IAD terkait rumah sakit di Unit Neonatal RSUPNCM adalah kelompok bakteri Gram negatif. Walaupun rate IAD pada penelitian memberikan hasil yang cukup rendah, namun berdasarkan perbandingan profil antibiogram isolat dari darah dan lingkungan menunjukkan profil antibiogram yang mirip bahkan identik.

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AbstractBackground: Hospital Acquired Infection (HAI)-Blood Stream infection (BSI) cause considerable morbidity, mortality and health care costs. This study aimed to assess the HAI-BSI in neonates with birth weight 1000-2000 g in Neonatal Unit Cipto Mangunkusumo National Hospital (RSUPNCM), Jakarta, during 4 months period (Oct 2010-Jan 2011), and to review the possibility of sources and transmission of environment microbes to the presence of HAI-BSI in the unit. Methods: Subjects of this study were neonates (birth weight 1000-2000 g) with clinically sepsis and within 48 hours or more being hospitalized, no clearly focal infection detected, with catheter lines. Two blood specimens from two separate venipunctures, drawn simultaneously, were cultivated. Identification and antimicrobial susceptibility tests were performed for each isolates. Cultures from environment in the unit and other suspected clinical specimens were also examined. Results: From 29 neonates with 39 episodes of sepsis, 5 positive isolates from blood cultures were obtained i.e. Enterobacter asburiae (2), Enterobacter cloacae (1), Pseudomonas aeruginosa (1) and Klebsiella oxytoca (1). The laboratory confirmed HAI-BSI was 12.8%, and HAI-BSI rate was 1.46 per 1000 catheter line days during 4 months period (Oct 2010-Jan 2011). Cultures performed for environment specimens gave yield some species which were as those from clinical specimens. Antibiogram analysis showed those of environment isolates i.e E. asburiae and P. aeruginosa shared similarity to those of neonates? blood isolates. Conclusion: Gram-negative bacteria were responsible to the occurrence of HAI-BSI in the Neonatal Unit RSUPNCM. Despite of low HAI-BSI rate found in this study, analysis of antibiogram profiles of the isolates originated from neonates? blood and environment strongly suggested that cross infection was present in the unit. "

"Dua puluh persen dari operasi tumor tulang membutuhkan tranfusi darah Packed Red Cell (PRC) intraoperatif, dengan volume tranfusi rata-rata 1200 ml.^1,2. Kelebihan permintaan darah menimbulkan kerugian biaya. Selama januari-juli 2017, RSCM mengalami kerugian Rp 5,381,100,000 akibat terbuangnya 7972 kantung darah. Penelitian ini bertujuan membuat model prediksi kebutuhan tranfusi PRC peribedah pada operasi tumor tulang berdasarkan faktor-faktor letak, ukuran, karakteristik keganasan tumor, nilai Hb prabedah dan nilai ASA prabedah. Penelitian ini memiliki desain kohort retrospektif dan dilakukan pada pasien dewasa yang menjalani pembedahan tumor pada tahun 2015-2017. Analisis dilakukan pada 82 data yang didapat dari rekam medis. Uji bivariat menunjukkan letak tumor, ukuran tumor, karakteristik keganasan tumor, nilai Hb prabedah dan nilai ASA prabedah memiliki hubungan bermakna terhadap kebutuhan tranfusi PRC perioperatif. Analisis multivariat regresi linier menunjukan hanya letak tumor dan nilai Hb prabedah yang merupakan prediktor bermakna. Model alternatif hasil regresi logistik dan analisis tambahan dibuat untuk menentukan probabilitas tranfusi PRC perioperatif.

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Twenty percent of bone tumor surgery requires intraoperative blood tranfusion, mostly Packed Red Cell (PRC). Approximately 1200ml or 4-6 unit of PRC transfusion is given in a bone tumor surgery.^1,2Less accurate estimation of the need of transfusion caused excessively wasted blood requests and led to high expense loss. In January-July 2017 there were 7972 wasted bags of blood product, resulting in a loss of Rp. 5,381,100,000 in Cipto Mangunkusumo Hospital. This study aimed to develop a prediction model for the need of perioperative red blood cell transfusion in bone tumor surgery. This is a retrospective cohort study of adults patients underwent bone tumor surgery between 2015 to 2017. Data was retrieved from the medical records and 82 subjects were included. The bivariate analysis showed that tumor location, size, malignancy, preoperative hemoglobin level and ASA physical status were significantly correlated with perioperative needs of red blood cell transfusion. However, the linear regression showed that only tumor location and preoperative hemoglobin level were considered as significant predictors. Therefore we obtained an alternative model from logistic regression to determine the probability of the need for perioperative PRC transfusion and add additional factors in the analysis."

"Latar belakang: Sepsis (infeksi) intra-abdomen (SIA) merupakan masalah klinik yang sampai saat ini merupakan mortalitas yang tinggi dan tantang tersendiri spesialis bedah. Dari data yang ada, insiden di Amerika Serikat pada tahun 2012 tercatat 3,5 juta penderita dengan mortalitas mencapai 60%, sedangkan di Eropa barat 30%. Timbul pertanyaan, faktor apa yang paling berperan dalam rantai perkembangan sepsis intra-abdomen. Dari informasi terkini tertuju pada biophenotype. Pada tahun 2007 istilah biophenotype diajukan oleh Human Nature Natural Health untuk menjelaskan suatu molekul yang terproyeksi dan melapisi permukaan seluruh sel yang ada di tubuh manusia. Tujuan Penelitian: Diketahuinya hubungan golongan darah tertentu dengan kejadian sepsis intra-abdomen pada pasien trauma abdomen dan infeksi gastrointestinal. Metode Penelitian: Penelitian ini merupakan penelitian deskriptif dan analtik dengan desain potong lintang. Subjek yang diambil merupakan pasien yang mengalami trauma abdmen dan infeksi gastrointestinal di RSCM melalui data rekam medis. Data yang diambil adalah usia, jenis kelamin, riwayat transfusi dengan golongan darah ABO, dan hasil kultur jaringan. Data tersebut dianalisis menggunakan SPSS dan dilakukan uji chi-square untuk mengetahui hubungan antara golongan darah ABO dengan kejadian sepsis.Hasil Penelitian: Pada penelitian ini ditemukan terdapat 22 subjek (9,6%) pasien yang mengalami sepsis intra abdomen pasca operasi selama periode Januari 2014-Maret 2016. Studi ini mendapatkan hubungan yang bermakna antara pemberian transfusi (OR = 0.02; p < 0.001) dan grup diagnosis (OR = 4.7; P = 0.015) terhadap terjadinya sepsis intra abdomen. Namun demikian, tidak ditemukan hubungan yang bermakna pada usia, jenis kelamin, dan golongan darah terhadap terjadinya sepsis intra abdomen. Kesimpulan: Dari hasil penelitian ini belum dapat dibuktikan golongan darah tertentu berpotensi menyebabkan sepsis intra abdomen pada pasien dengan riwayat trauma abdomen dan infeksi gastro intestinal.

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Background: Intra-abdominal sepsis is a clinical problem with high mortality and a special challenge for surgeons. Based on research about glycocalyx, we obtained information regarding the differences of biophenotype on glycocalyx. So far, the research that leads to the difference in biophenotype is only focused on the ABO blood type system. Until recently there has been no data on the relationship between sepsis (especially intra-abdominal sepsis) with blood type. Methods: This is a descriptive and analytic research with cross sectional design in patients with abdominal trauma and gastrointestinal infections at dr. Cipto Mangunkusumo General Hospital (RSCM) that fulfilled the inclusion and exclusion criteria.Results: There were 230 subjects, who underwent post-traumatic abdominal surgery as well as gastrointestinal infections at RSCM. There were 22 subjects (incidence: 9.6%) who had postoperative intraabdominal sepsis. Most subjects who underwent surgery were aged around 41-60 years (50%), were men (56.1%), did not get transfusions (90.9%), had surgery caused by mechanical intestinal obstruction (24.8%), had blood type O (46.1%), had gastrointestinal infection (92.6%), and were living as the outcome of the procedure (96.5). There was a significant correlation (p < 0,05) between transfusion (p = 0,0001) and diagnostic group (p = 0,015) on the occurrence of intra-abdominal sepsis. In subjects receiving transfusion, the odds ratio (OR) was 0.02 and the group diagnosis OR was 4.7 at 95% confidence interval. Conclusions: The high risk of sepsis is especially high in the gastrointestinal infection group. Similarly, amongst factors affecting sepsis, history of transfusion may increase the risk of sepsis. Results of this study could not be prove that certain blood groups potentially cause intra-abdominal sepsis in patients with a history of abdominal trauma and gastro intestinal infections."

"Prevalensi tinggi Infeksi Saluran Pernafasan Akut (ISPA) pada Indonesia merupakan masalah kesehatan yang terkadang dianggap remeh. Presentasi gejala batuk dan pilek mampu menurunkan kualitas kehidupan masyarakat. Namun, pola transmisi ISPA yang multifaktorial mempersulit tindakan pencegahan. Seiring perkembangan teknologi, ditemukan bahwa antigen golongan darah ABO berperan dalam invasi patogen, sehingga dapat meningkatkan maupun menurunkan kerentanan transmisi. Namun, karena belum ada studi yang membahas tentang pengaruh perbandingan golongan darah ABO terhadap kerentanan transmisi ISPA, maka akan dilakukan studi untuk menjawab pertanyaan tersebut. Penelitian ini dilaksanakan dengan melibatkan 175 perwakilan keluarga inti yang berdomisili di daerah Jabodetabek melalui pendekatan potong lintang. Data penelitian diperoleh dari jawaban kuesioner online menggunakan platform Qualtrics. Data yang didapat akan selanjutnya dirapikan dan dianalisis dengan IBM SPSS Statistics for Windows versi 24.0. Untuk mengetahui ada tidaknya perbedaan bermakna antara waktu inkubasi ISPA antara anggota keluarga inti dengan golongan darah sama dan berbeda, akan dilakukan analisis komparatif Mann Whitney. Didapatkan proporsi anggota keluarga inti yang terjangkit oleh anggota keluarga inti lain dengan golongan darah sama (kondisi 1) dan berbeda (kondisi 2) berturut-turut 44,7% dan 30,8%. Median dan modus dari waktu inkubasi ISPA kondisi 1 berturut-turut lebih dari 21 hari dan lebih dari 28 hari, sedangkan median dan modus waktu inkubasi ISPA kondisi 2 adalah lebih dari 28 hari. Terdapat perbedaan waktu inkubasi yang signifikan secara statistik antara kondisi 1 dan 2 (p = 0,009). Ditemukan pengaruh signifikan dari perbandingan golongan darah ABO pada anggota keluarga inti terhadap kerentanan transmisi ISPA dengan kecenderungan golongan darah yang sama mempercepat waktu inkubas

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High prevalence of acute respiratory infection (ARI) issue in Indonesia is usually underestimated despite its influence on society’s quality of life. However, multifactorial ARI transmission hinders prevention effort. As technology evolves, the role of ABO blood antigen in pathogen invasion that affects transmission vulnerability is discovered. Since no study has been established to analyze the impact of ABO blood group comparison toward ARI transmission vulnerability, this research is held in order to find the missing link. This research was conducted via cross sectional approach by involving 175 representatives of nuclear families who live in Jabodetabek. The acquired data obtained from online questionnaire will then be organized and analyzed with IBM SPSS Statistics for Windows version 24.0. To find out whether there is a significant difference of ARI incubation time between nuclear family members with the same and different ABO blood groups, Mann Whitney comparative analysis will be carried out. The proportion of nuclear family members infected by other family members with the same (condition 1) and different (condition 2) blood group was 44.7% and 30.8% respectively. The median and modus of ARI incubation time from condition 1 consecutively was more than 21 days and more than 28 days, whereas the median and modus of ARI incubation time from condition 2 was more than 28 days. There was a statistically significant difference in incubation time between condition 1 and 2 (p = 0.009). Significant effect was discovered statistically between ABO blood group comparison at nuclear family members toward the susceptibility of ARI transmission where similar ABO blood groups have faster tendency of incubation time."

"ABSTRAKThe scarcity of blood that is still happening today is the result of a combination of high blood needs and the difficulty of recruiting and maintaining donors. There is no research discover the substitute that can replace the role of blood, therefore the only source is from donations or blood donors. Approximately 80% of total blood donations collected by American Red Cross are come from blood drive events. Because blood has 6-hour spoilage time, donated blood at various donation locations must be collected and sent to a blood center for processing in less than 6 hours. This research study the Maximum Blood Collection Routing Problem (MBCRP). This problem is the extension of Vehicle Routing Problem with Time-Window (VRPTW) by considering the spoilage time limitation in blood. A mathematical model with objective to maximize total blood collection is built to cope with this problem. The mathematical model will be tested for verification and validation. The model is written in a computer programming language using AMPL software and is solved using the CPLEX solver. Furthermore, the results of verification and validation tests will be evaluated to see the applicability of the model."

"ABSTRAKAmerican Dream adalah etos nasional dari negara Amerika Serikat; sebuah konsep dimana semua orang bisa menjadi sukses di Amerika Serikat jika bekerja keras. Meskipun terkesan positif, sisi lain dari American Dream yang bisa menjadi berbahaya bagi orang-orang yang mempercayainya sering menjadi tema dari banyak karya literatur dan film. Penelitian ini mencoba untuk menganalisis There Will Be Blood, sebuah film karya sutradara Paul Thomas Anderson yang dirilis tahun 2007, sebagai kritik kepada konsep American Dream. Hasil dari penelitian ini menunjukkan bahwa film There Will Be Blood ini menunjukkan konsep American Dream itu tidak seideal kelihatannya

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ABSTRACTThe American Dream is the national ethos of the United States; a dream that everyone has a chance to success through hard work. The possibility that the pursuit of American Dream can be dangerous and lethal is used as a recurring theme in many literature works and films. This paper attempts to analyze There Will Be Blood, a 2007 film by Paul Thomas Anderson, as a critique to American Dream concept. This research will use James Truslow Adams definition of American Dream as a framework. The result of the study shows that the concept of American Dream is not as ideal as it seems in the movie There Will Be Blood."

"Tujuan penelitian ini adalah untuk mengetahui apakah terdapat perbedaan antara hasil pemeriksaan hematologi rutin dan morfologi darah tepi eritrosit pada sampel darah dengan berbagai konsentrasi antikoagulan Na2EDTA yang berbeda. Penditian ini merupakan penelitian potong lintang. Bahan penelitian berupa 33 sampel darah vena mahasiswa Fakultas Kedokteran UGM Yogyakarta. Dua ml darah dibagi ke datum 4 tabling Na2EDTA yang masing-masing berisi antikoagulan dengan konsentrasi yang berbeda. Tabung pertama berisi Na2EDTA konsentrasi standar, 2 mg/dl, tabung yang lain secara berurutan berisi Na2EDTA dengan konsentrasi 4 mg/dl, 6 mg/dl, and 8 mg/dl. Sebelumnya dibuat sediaan hapus langsung dari setetes darah tanpa antikoagulan (sebagai kontrol) untuk pemeriksaan morfologi darah tepi (MDT). Darah dalam keempat tabung tersebut segera dilakukan pembuatan sediaan hapus dan diperiksa profit hematologi eritrositnya menggunakan SYSMEX SE-9500 automatic analyzer. Terdapat penurunan yang bermakna dari hitung eritrosit, hemoglobin, hematokrit, dan MCHC serta peningkatan yang bermakna dari nilai MCV dan RDW antara konsentrasi Na2EDTA yang berlebihan, sedangkan nilai MCH tidak ada perbedaan. Pemeriksaan MDT menunjukkan perubahan yang bermakna pada bentuk echinocytes serta ditemukan gambaran ghost cells pada sampel darah dengan Na2EDTA yang berlebihan. Disimpulkan bahwa antikoagulan Na2EDTA yang berlebihan akan berpengaruh terhadap morfologi dan beberapa parameter hematologi eritrosit. (Med J Indones 2006; 15:157-64)

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The purpose of this study is to know whether there are differences between hematology profile and morphology of erythrocyles of blood specimens which are prepared with excessive Na2EDTA anticoagulant in different concentration. This study was conducted in Faculty of Medicine Gadjah Mada University. The criteria of subject were male, age from 18 until 22 years old and healthy, ascertained from history taking and vital sign examination. Blood samples from 33 subjects were taken using vein puncture. Two millimeters blood was divided into 4 Na2EDTA-containing tube's. Before that, one drop of blood without Na2EDTA anticoagulant was used for making control blood film right after vein puncture. Each tubes contained different concentration of anticoagulant. The first tube contained Na2EDTA in standard concentration 2 mg/dl; the remaining tubes contained consecutively, 4 mg/dl, 6 mg/dl, and 8 mg/dl. Those samples were immediately examined using SYSMEX SE-9500 automatic analyzer for measuring erythrocytes hematological profile and were stained with Wright staining far morphological examination. These procedures were done before 20 minutes of vein puncture. There were significant decrease ofRBC count, HGB, HCT, and MCHC and also significant increase of MCV and RDW between different concentrations of excessive Na2EDTA anticoagulant. MCH did not have significant result. Morphological examination showed significant morphological changes in the form of echinocytes and appearance of ghost cells in the sample treated with excessive Na2EDTA anticoagulant concentration. In conclusion, there are differences in hematological profile and morphology of erythrocytes among blood specimen which are prepared with excessive Na2EDTA anticoagulant in different concentration, except for MCH. Excessive Na2EDTA anticoagulant concentration will affect the blood specimen for peripheral blood examination of erythrocytes by interfering morphology and some of hematological parameters. (Med J Indones 2006; J 5:157-64)"

"Latar belakang: Infeksi saluran cerna dengan manifestasi klinis berupa diare merupakan penyakit infeksi dengan kesakitan dan kematian yang tinggi terutama di negara-negara yang sedang berkembang. Diare menimbulkan kematian terutama pada bayi baru lahir di bawah 1 tahun. Penanganan telah ditingkatkan secara terus menerus, namun demikian kemajuan dalam diagnosis maupun pengobatan tidak terjangkau oleh negara-negara yang sedang berkembang. Salah satu penyebab infeksi saluran cerna adalah bakteri. Oleh karenanya dengan mengetahui bakteri penyebab serta pola resistensi bakteri terhadap antibiotik dapat menunjang penatalaksanaan penyakit ini. Studi ini dilakukan untuk mengetahui berbagai jenis mikroba yang diisolasi dari saluran cerna serta pola resistensinya terhadap beberapa antibiotik.Metode: Spesimen berupa tinja, usap dubur atau anus yang diterima oleh Laboratorium Mikrobiologi FKUI selama 2005- 2008. Isolasi, identifi kasi kepekaan dan uji antibiotik dikerjakan sesuai prosedur standar yang berlaku. Interpretasi hasil uji kepekaan menggunaan panduan NCCLS/CLSI. Data dianalisis menggunakan WHOnet versi 5.3.Hasil: Diperoleh 28 isolat Escherichia coli patogen, 1 isolat Salmonella paratyphi A, dan 4 isolat ragi yang diisolasi dari tinja dan swab dubur penderita. Walaupun Escherichia coli patogen masih peka terhadap beberapa antibiotik, namun kepekaannya menurun terhadap amoxicillin, sulbenicillin, ticarcillin dan trimethoprim/rulfamethoxazole.Kesimpulan: Escherichia coli patogen merupakan bakteri terbanyak yang berhasil diisolasi dari tinja/usap dubur. Bakteri ini telah menunjukkan penurunan kepekaan terhadap beberapa antibiotik yang sering digunakan untuk mengobati infeksi saluran cerna. (Med J Indones 2011; 20:105-8).

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AbstractBackground: Digestive tract infection with clinical manifestation of diarrhea is an infectious disease that has the highest morbidity and mortality rate, especially in developing countries. Diarrhea causes mortality mostly in infants under one year old. Improvement in management is done continuously, but advances in diagnosis and therapy cannot be reached by developing countries. One of the etiological agents causing infection of digestive tract is bacteria. Therefore, knowledge of bacteria that cause gastrointestinal infection and their resistance patterns may support the management of this disease. The aim of this study was to examine microbes that were isolated from the digestive tract and their resistance patterns against antibiotics.Methods: Samples (stool, rectal/anal swab) were collected from the Clinical Microbiology Laboratory, FKUI during 2005-2008. Isolation, identifi cation and sensitivity test were conducted according to standard laboratory procedures. Interpretation of sensitivity test was done according to NCCLS/CLSI guidance. Data was analyzed using WHOnet version 5.3.Results: We found 28 isolates of pathogenic Escherichia coli, 1 isolate of S. paratyphi A and 4 isolates of yeasts. Pathogenic Escherichia coli were still sensitive against some antibiotics, but the sensitivity was reduced against amoxicillin, sulbenicillin, ticarcillin and trimethoprim/sulfamethoxazole.Conclusion: The most predominant gastrointestinal tract infection causing microbes was pathogenic Escherichia coli. These bacteria showed decrease sensitivity against some antibiotics commonly used to treat patients with gastrointestinal tract infection. (Med J Indones 2011; 20:105-8)"