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"ABSTRAK Soluble CD14-ST presepsin merupakan penanda sepsis baru untuk diagnosis dan prognosis sepsis neonatorum. Kadar presepsin meningkat pada keadaan sepsis disebabkan oleh aktivitas protease di fagolisosom. Penelitian ini bertujuan untuk mengetahui manfaat pemeriksaan serial kadar presepsin sebagai penanda pemantauan respons terapi dan prognosis pada pasien SNAL secara bedside dengan menggunakan sampel darah kapiler. Desain penelitian kohort prospektif. Subjek penelitian terdiri dari 20 neonatus sehat dan 42 pasien SNAL. Pemeriksaan kadar presepsin dengan alat Pathfast pada hari ke-1, ke-3, dan ke-6 setelah diterapi. Kadar presepsin pada pasien SNAL 1104 pg/mL (608 ? 6225 pg/mL) lebih tinggi dibandingkan pada neonatus sehat 448 pg/mL (191 ? 513 pg/mL), nilai p 0,000. Pada pasien SNAL kelompok respons terapi kadar presepsin lebih rendah dibandingkan dengan kelompok non respons pada hari ke-3 dan ke-6 (p<0,05). Pada pasien SNAL kelompok non survivor kadar presepsin lebih tinggi dibandingkan dengan kelompok survivor hari ke-6 (p<0,05). Kadar presepsin berkorelasi positif dengan kadar CRP (r=0,488) dan jumlah leukosit (r=0,321). Nilai cut-off kadar presepsin hari ke-6 untuk penentuan prognosis 1365 pg/mL mempunyai AUC 0,789 (IK 95% 0,652 ? 0.926), sensitivitas 90.9%, dan spesifisitas 67,7%. Pemeriksaan presepsin hari ke-3 atau ke-6 secara bedside dengan darah kapiler bermanfaat untuk pemantauan terapi dan prognostik pasien SNAL.ABSTRACT Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient.;Soluble CD14-ST presepsin as a new septic marker for diagnostic and prognostic of neonatal sepsis. Concentration of presepsin significantly increases in bacterial sepsis induced by phagolysosome protease activity. The objective of this study is to investigate the prognostic and monitoring value of presepsin in late onset neonatal sepsis (LOS) with serial capillary whole blood assay. This was prosphective cohort, from 20 healthy neonates and 42 LOS patient. The concentration of presepsin was analysed using Pathfast analyzer at 1st, 3rd & 6th day after therapy. Median of presepsin in LOS patient is 1104 pg/mL (608 ? 6225 pg/mL) significantly higher than healty neonates 448 pg/mL (191 ? 513 pg/mL), p value 0.000. Median of presepsin at 3rd & 6th day after therapy in LOS with therapeutic respons is significantly lower than LOS with no respons (p<0.05). Median of presepsin at 6th day after therapy in nonsurvivor is significantly higher than in survivor (p<0.05). There are positive correlation between presepsin and CRP (r=0.488) or leucocyte count (r=0.321). Cut-off presepsin at 6th day after therapy 1365 pg/mL is found with AUC 0.789 (CI 95% 0.652 ? 0.926), sensitivity 90.9%, dan spesificity 67.7%. Presepsin assay at 3rd or 6th day after therapy with capillary whole blood can be used to predict the prognostic and therapeutic respons in LOS patient."

"Sepsis merupakan tantangan besar di dunia kedokteran. Terdapat banyak penelitian yang mencari penanda sepsis yang handal dan soluble Cluster of Differentiation-14 subtype (sCD14-ST) mulai banyak diteliti sebagai penanda sepsis. Kadar sCD14-ST meningkat secara bermakna di dalam sirkulasi pada fase awal inflamasi dan sepsis. Saat ini belum terdapat data mengenai apakah sCD14- ST dapat digunakan sebagai penanda prognostik sepsis. Tujuan penelitian ini dilakukan untuk mengetahui apakah sCD14-ST dapat digunakan sebagai penanda prognostik pada pasien sepsis yang datang di instalasi gawat darurat. Desain penelitian potong lintang, terdiri dari 65 pasien sepsis dibagi bedasarkan mortalitas 28 hari, yaitu 37 pasien hidup dan 28 pasien meninggal. Diagnosis sepsis berdasarkan modifikasi definisi sepsis oleh International Sepsis Definitions Conference 2001. Kadar sCD14-ST didapatkan menggunakan pemeriksaan dengan prinsip noncompetitive chemiluminescent enzyme immunoassay pada alat Pathfast. Pada kedua kelompok tersebut dicatat data karakteristik subyek dan dilakukan pemeriksaan sCD14-ST. Median kadar sCD14-ST pada pasien hidup adalah 618,00 pg/mL dengan rentang 349,50 - 1628 pg/mL dan median kadar sCD14-ST pada pasien yang meninggal adalah 1287,00 pg/mL dengan rentang 720,75 - 2738,00 pg/mL. Terdapat perbedaan bermakna kadar sCD14-ST pada kedua kelompok dengan nilai p 0,005. Ditentukan nilai cut-off sCD14-ST 677,00 pg/mL untuk menentukan prognosis pasien sepsis, dengan AUC 0,706 (IK 95% 0,582 - 0,831), sensitivitas 82,1%, dan spesifisitas 54,1%. Kurva Kapplan Meier berdasarkan nilai cut-off 677,00 pg/mL menunjukkan gambar yang memenuhi asumsi proporsional hazard dengan rasio hazard 3,794 (IK 95% 1,437 - 10,013), p 0,007. Kami menyimpulkan kadar sCD14-ST pasien sepsis dapat digunakan untuk memprediksi pasien yang meninggal dilihat dari mortalitas 28 hari, dengan nilai AUC sedang. Cut-off kadar sCD14-ST 677,00 pg/mL dapat digunakan sebagai cut-off dalam tatalaksana pasien sepsis.

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Sepsis is a major challenge in the medicine world. Many studies try to find

reliable sepsis marker and scientists start to explore soluble Cluster of Differentiation-14 subtype (sCD14-ST) as sepsis marker. Concentration of sCD14-ST significantly increases in circulation on early phase of inflammation and sepsis. Nowadays there is no data whether sCD14-ST can be used as prognostic marker of sepsis.

The objective of this study is to investigate the prognostic value of sCD14-ST in sepsis patients presenting at the emergency department. This was a cross-sectional study, from 65 sepsis patient grouped based on 28-day mortality, 37 patients are survivors and 28 patients are nonsurvivors. Sepsis diagnosis is made based on modified sepsis definition from International Sepsis Definitions Conference 2001. The concentration sCD14-ST was analysed using Pathfast analyzer with noncompetitive chemiluminescent enzyme immunoassay test method. Baseline characteristics of subjects were recorded and sCD14-ST concentration were measured in study subjects.

Median of sCD14-ST in the survivors group is 618,00 pg.mL with range of 349,50 - 1628,00 pg/mL and the median in the nonsurvivors group is 1287,00 pg/mL with range of 720,75 - 2738,00 pg/mL. The difference between the two groups is significant with p 0,005. sCD14-ST cut-off of 677,00 pg/mL is found with AUC 0,706 (CI 95% 0,582 - 0,831), sensitivity 82,1%, and specificity 54,1%. Kapplan Meier curve based on 677,00 pg/mL cut-off demonstrates that hazard proportion is fulfilled with hazard ratio 3,794 (CI 95% 1,437 - 10,013), p 0,007.

It is concluded that sCD14-ST concentration in sepsis patients can be used to predict nonsurvivors based on 28-day mortality, with moderate AUC. Cut-off sCD14-ST of 677,00 pg/mL can be used as cut-off for sepsis patient management."

"ABSTRAK Diagnosis infark miokard akut ditegakkan apabila memenuhi 2 dari 3 kriteria, yaitu klinis, perubahan EKG, dan peningkatan kadar penanda biokimia jantung. Troponin merupakan penanda biokimia jantung yang spesifik untuk infark miokard, akan tetapi memiliki keterbatasan yaitu kurang sensitif apabila dilakukan pada fase awal karena troponin akan meningkat dalam darah setelah 4 -10 jam setelah infark miokard. Copeptin merupakan penanda stres endogen, yang dapat meningkat pada awal onset infark miokard akut, namun kurang spesifik. Penelitian tentang copeptin-us sebagai penanda biokimia jantung masih sedikit dan di Indonesia penelitian tentang copeptin-us sebagai penanda biokimia jantung belum pernah dilakukan.Penelitian ini mengikutsertakan 91 pasien tersangka sindrom koroner akut yang terbagi atas 15 (16,5%) NSTEMI, 43 (47,3%) UA, dan 33 (36,3%) non SKA. Diagnosis ditegakkan oleh dokter di IGD RS Jantung dan Pembuluh Darah Harapan Kita. Karakteristik pasien yang memenuhi kriteria inklusi dan eksklusi dicatat dan kemudian dilakukan pemeriksaan copeptin-us.Nilai rerata copeptin-us pada NSTEMI adalah 151,80 ± 130,03 pmol/L, median copeptin-us pada UA adalah 7,12(1,145 ? 62,23) pmol/L, dan rerata copeptin-us pada non SKA adalah 7,36 ± 4,17 pmol/L. Nilai cut off copeptin-us untuk membedakan NSTEMI dengan UA/non SKA adalah 13,97 pmol/L. Area under curve (AUC) kombinasi hs-cTnT saat masuk rumah sakit dengan copeptin-us adalah 0,941 (0,882 ? 1,00), hs-cTnT saat masuk rumah sakit 0,885 (0,790 ? 0,98), dan AUC hs-cTnT 3 jam kemudian adalah 0,925 (0,824 ? 1,00). Nilai median hs-cTnT saat masuk RS pada NSTEMI adalah 114(29-1102) pg/mL, pada UA adalah 16 (3-3352) pg/mL, dan pada non SKA adalah 6(3-366) pg/mL. Nilai median hs-cTnT 3 jam pada NSTEMI adalah 488 (81-18437) pg/mL, pada UA 14(3-2224) pg/mL, dan pada non SKA adalah 3(3-679) pg/mL. Kombinasi copeptin-us ≥ 13,97 pmol/L dan hs-cTnT ≥ 14 pg/mL dan untuk membedakan NSTEMI dengan UA/non SKA memberikan sensitivitas 100%, spesifisitas 90,78%, NPP 68,18%, dan NPN 100%.Uji diagnostik kombinasi copeptin-us dan hs-cTnT saat masuk RS lebih baik dibandingkan hs-cTnT saat masuk RS saja dan dapat digunakan untuk rule out NSTEMI.ABSTRACT Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done.In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured.The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%.The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI.;Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done.In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured.The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%.The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI.;Diagnosis of acute myocardial infarction is made when two of the followed criterias are met; clinical, ECG changes, and increased levels of cardiac biochemical markers. Troponin is a specific cardiac biochemical marker for myocardial infarction but has limitation. It is less sensitive when measured in the early phase, because troponin will increase in blood after 4 -10 hours post myocardial infarction. Copeptin is an endogenous stress marker, it level increases in the early onset of acute myocardial infarction but study on copeptin-us as cardiac biochemical marker are limited and in Indonesia there is no study on copeptin-us has been done.In this study 91 consecutive patients fulfilled the inclusion and exclusion criteria, consist of 15 (16,5%) NSTEMI, 43 (47,3%) unstable angina, and 33 (36,3%) non acute coronary syndrome. Diagnosis was made by the emergency physician at Harapan Kita cardiovascular centre. Characteristics of these subject were recorded and then the copeptin-us levels were measured.The mean value of copeptin-us in NSTEMI is 151,80 ± 130,03 pmol/L, median copeptin-us in UA is 7,12(1,145 ? 62,23) pmol/L, and the mean copeptin-us in non ACS is 7,36 ± 4,17 pmol/L. Cut off value of copeptin-us to distinguish NSTEMI from UA/non ACS is 13,97 pmol/L. Area under curve of the combination hs-cTnT on admission and copeptin-us is 0,941 (0,882 ? 1,00), hs-cTnT on admission is 0,885 (0,790 ? 0,98), and hs-cTnT 3 hours laters is 0,925 (0,824 ? 1,00). Median value hs-cTnT on admission in NSTEMI is 114(29-1102) pg/mL, in UA is 16 (3-3352) pg/mL, and in non ACS is 6(3-366) pg/mL. Median hs-cTnT 3 hours in NSTEMI is 488(81-18437) pg/mL, in UA is 14(3-2224) pg/mL, and in non ACS is 3(3-679) pg/mL. Combination of copeptin-us ≥ 13,97 pmol/L and hs-cTnT ≥14 pg/mL to distinguish NSTEMI from UA/non ACS has sensitivity 100%, specificity 90,78%, PPV 68,18%, and NPV 100%.The diagnostic value of combination on copeptin-us and hs-cTnT is better than only hs-cTnT on admission so that it can be used to rule out NSTEMI."

"ABSTRAK Pendahuluan: Biopsi jarum inti dianggap memiliki hasil akurasi yang samadengan biopsi terbuka dan telah menjadi prosedur rutin untuk menegakkandiagnosis lesi muskuloskeletal. Namun demikian uji diagnostik biopsi jarum intidi Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSUPN CM)belum dilaporkan. Tujuan dari analisis retrospektif ini adalah untuk mendapatkannilai ketepatan diagnosis biopsi jarum inti pada lesi muskuloskeletal.Metode: Dari Januari 2011 hingga Agustus 2015, semua pasien dengan lesi muskuloskeletal di RSUPN CM yang menjalani biopsi jarum inti dan eksisi tumor diidentifikasi dan diambil datanya. Ketepatan diagnosis dianalisis baik untukkesimpulan histopatologi maupun kesimpulan clinical pathology conference(CPC).Hasil: Sebanyak 86 sampel dikumpulkan dalam penelitian ini. Ketepatandiagnosis biopsi jarum inti dibandingkan dengan spesimen pasca eksisi adalah74,4%. Setelah dilakukan CPC, nilai ketepatan menjadi 83,7% dengan sensitivitas98%, spesifisitas 59%, NDP 87%, NDN 93% (p = 0.00). Ketepatan biopsi jaruminti setelah pulasan imunohistokimia naik menjadi 84,9% (p = 0,438). Ketepatanuntuk membedakan lesi jinak dan ganas adalah 97,1% (jinak) dan 82,7% (ganas)(p = 0.00). Ketepatan untuk membedakan lesi primer dan metastasis adalah 97,2%(primer) dan 85,7% (metastasis) (p = 0.00).Diskusi: Kami mendapatkan nilai ketepatan biopsi jarum inti yang sedikit lebihrendah karena dalam penelitian ini dituntut untuk membuat diagnosis sampaitingkat morfologi (ICD O dan ICD X). Namun demikian, dengan modalitas lainseperti imunohistokimia dan kesimpulan CPC, ketepatan menjadi meningkat.Ketepatan diagnosis untuk membedakan lesi jinak-ganas dan primer-metastasis tinggi. Biopsi jarum inti direkomendasikan untuk penegakkan diagnosis lesi muskuloskeletal.ABSTRACT Introduction: Core needle biopsy is considered to have similar results with openbiopsy in accuracy and already become a routine procedure to establish thediagnosis of musculoskeletal lesion. However, diagnostic test of core needlebiopsy application in Cipto Mangunkusumo Hospital has not been reported.Therefore, the aim of this retrospective analysis was to attain the accuracy ofmusculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy andsubsequent tumour excision were indentified and enrolled. Diagnostic accuracywere calculated for both histopathology and clinical pathology conference (CPC)conclusion.Results: A total of 86 samples were indentified and enrolled in this study. Theaccuracy of core needle biopsy compared to subsequent excision is 74.4%. WithCPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguishprimary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=0.00). Discussion: We found slightly inferior results for core needle biopsy accuracycompared to literature due to high specificity diagnosis obligatory (ICD O andICD X morphology) in our study. However, with other modalities such asimmunohistochemistry and CPC, the accuracy is increased. The accuracy todistinguish between benign vs malignant and primary vs metastatic lesion is high.Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.;Introduction: Core needle biopsy is considered to have similar results with openbiopsy in accuracy and already become a routine procedure to establish thediagnosis of musculoskeletal lesion. However, diagnostic test of core needlebiopsy application in Cipto Mangunkusumo Hospital has not been reported.Therefore, the aim of this retrospective analysis was to attain the accuracy ofmusculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy andsubsequent tumour excision were indentified and enrolled. Diagnostic accuracywere calculated for both histopathology and clinical pathology conference (CPC)conclusion.Results: A total of 86 samples were indentified and enrolled in this study. Theaccuracy of core needle biopsy compared to subsequent excision is 74.4%. WithCPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguishprimary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=0.00). Discussion: We found slightly inferior results for core needle biopsy accuracycompared to literature due to high specificity diagnosis obligatory (ICD O andICD X morphology) in our study. However, with other modalities such asimmunohistochemistry and CPC, the accuracy is increased. The accuracy todistinguish between benign vs malignant and primary vs metastatic lesion is high.Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions.;Introduction: Core needle biopsy is considered to have similar results with openbiopsy in accuracy and already become a routine procedure to establish thediagnosis of musculoskeletal lesion. However, diagnostic test of core needlebiopsy application in Cipto Mangunkusumo Hospital has not been reported.Therefore, the aim of this retrospective analysis was to attain the accuracy ofmusculoskeletal lesion diagnosis using core needle biopsy. Methods: From January 2011 to August 2015, all patients with musculoskeletal lesion in Cipto Mangunkusumo Hospital underwent core needle biopsy andsubsequent tumour excision were indentified and enrolled. Diagnostic accuracywere calculated for both histopathology and clinical pathology conference (CPC)conclusion.Results: A total of 86 samples were indentified and enrolled in this study. Theaccuracy of core needle biopsy compared to subsequent excision is 74.4%. WithCPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59%,PPV 87%, NPV 93% (p=0.00). The accuracy with immunohistochemistry is84.9% (p=0.438). The accuracy to distinguish benign and malignant lesion is 97.1% (benign) and 82.7% (malignant) (p= 0.00). The accuracy to distinguishprimary and metastatic lesion is 97,2% (primary) and 85,7% (metastatic) (p=0.00). Discussion: We found slightly inferior results for core needle biopsy accuracycompared to literature due to high specificity diagnosis obligatory (ICD O andICD X morphology) in our study. However, with other modalities such asimmunohistochemistry and CPC, the accuracy is increased. The accuracy todistinguish between benign vs malignant and primary vs metastatic lesion is high.Core needle biopsy is recommended to establish diagnosis for selected musculoskeletal lesions."

"ABSTRAK Penggunaan transportasi tabung pneumatik di laboratorium berpotensi mengakibatkan kerusakan sel darah dan mempengaruhi hasil pemeriksaan Penelitian ini bertujuan mendapatkan data perbedaan hasil pemeriksaan jumlah eritrosit leukosit trombosit LDH kalium dan indeks hemolisis antara darah yang ditransportasi kurir dan tabung pneumatik Desain penelitian potong lintang dengan 58 subjek menggunakan darah K3EDTA berpasangan dan darah beku berpasangan Pada penelitian ini tidak ada perbedaan statistik pada jumlah eritrosit leukosit trombosit dan kalium antara kedua cara transportasi Terdapat peningkatan LDH dan indeks hemolisis yang bermakna secara statistik pada darah yang ditransportasi tabung pneumatik Peningkatan LDH melebihi batas ketelitian laboratorium tetapi tidak bermakna secara klinis ABSTRACT The use of pneumatic tube system has a possibility to induce damage on blood cells and affects laboratory result This study aim to obtain the difference between the result of erythrocyte leukocyte thrombocyte LDH kalium and hemolysis index in blood transported by courier and by pneumatic tube system The method used was a cross sectional study with 58 voluntary subjects using paired K3EDTA blood and paired coagulated blood There was no significant statistical difference between erythrocyte leukocyte thrombocyte count and kalium in blood transported by courier and by pneumatic tube system There was an increased in LDH and hemolysis index in blood transported by pneumatic tube The increase of LDH caused by pneumatic tube was higher than laboratory precision limit but not clinically significant "

"Pendahuluan: C-reactive protein CRP dan procalcitonin PCT merupakan penanda diagnostik dan pemantauan sepsis neonatorum yang paling banyak digunakan. Saat ini terdapat penanda sepsis baru yaitu Soluble CD14 subtype sCD14-ST presepsin. Penelitian ini bertujuan untuk mengetahui manfaat pemeriksaan serial kadar presepsin, CRP dan PCT serta korelasi antara kadar presepsin dengan kadar CRP dan PCT sebagai penanda respons terapi dan prognosis pasien SNAL pada neonatus prematur. Metode: Desain penelitian kohort prospektif. Subjek penelitian terdiri dari 40 neonatus prematur sehat dan 40 pasien neonatus prematur SNAL dan dilakukan pemeriksaan kadar presepsin, CRP dan PCT, selanjutnya dilakukan pemantauan kadar presepsin, CRP dan PCT pasien neonatus prematur SNAL hari ke-3 dan ke-6 setelah diterapi. Pasien neonatus prematur SNAL dikelompokkan menjadi 20 pasien respons terapi dan 20 pasien non respons. Mortalitas pasien neonatus prematur SNAL ditentukan pada pemantauan hari ke-30. Hasil: Median kadar presepsin, CRP dan PCT pada neonatus prematur SNAL masing-masing adalah 1559 pg/mL 427 ndash; 4835 pg/mL, 16.35 mg/L 0.1 ndash; 245.6 dan 4.11 ng/mL 0.17 ndash; 54.18 lebih tinggi secara bermakna dibandingkan pada neonatus prematur sehat 406 pg/mL 195 ndash; 562 pg/mL, 1.22 mg/L 0.1 ndash; 3.69 dan 0.03 0.01 ndash; 0.04 dengan nilai p.

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Introduction: C reactive protein CRP and procalcitonin PCT are marker of neonatal sepsis diagnostics and monitoring of the most widely used. Currently there is a new marker of sepsis that is Soluble CD14 subtype sCD14 ST presepsin. This study aims to determine the benefits of serial presepsin levels, CRP and PCT as well as the correlation between presepsin with CRP and PCT as a marker of response to therapy and prognosis of patients SNAL in premature neonates.

Methods. This was prospective cohort, from 20 healthy preterm neonates and 40 LOS preterm neonates patient. The concentration of presepsin, CRP and PCT were analysed. Presepsin, CRP and PCT measured in both group and in 3rd 6th day sepsis follow up after therapy. Therapeutic respons was done in 20 LOS preterm neonates patient and 20 preterm neonates patient was not. The mortality of LOS preterm neonates patient saw in 30th day observation.

Results: Median of presepsin, CRP and PCT in LOS preterm neonates are 1559 pg mL 427 ndash 4835 pg mL, 16.35 mg L 0.1 ndash 245.6 and 4.11 ng mL 0.17 ndash 54.18, respectively, are significantly higher than healty preterm neonates 406 pg mL 195 ndash 562 pg mL, 1.22 mg L 0.1 ndash 3.69 and 0.03 0.01 ndash 0.04, p value "

"Laboratorium memiliki potensi bahaya dan risiko yang cukup tinggi karena dalam aktivitas pekerjaannya terkait dengan penggunaan bahan-bahan dan peralatan yang berbahaya. Tidak terkecuali di Laboratorium FKUI yang dalam proses kerjanya sering menggunakan bahan-bahan kimia dan biologi. Terdapat berbagai macam upaya yang dapat dilakukan untuk meminimalisasi risiko K3 di tempat kerja, salah satunya adalah dengan cara memberikan pelatihan K3 guna meningkatkan skill dan pengetahuan para pekerja tentang K3. Sebelum melaksanakan suatu pelatihan maka terlebih dahulu perlu dilakukan analisis kebutuhan pelatihan. Analisis kebutuhan pelatihan terdiri dari tiga tahap analisis, yaitu analisis organisasi, analisis personal dan analisis tugas. Tujuan dari penelitian ini adalah untuk menganalisis kebutuhan pelatihan K3 yang diperlukan oleh para Laboran sehingga pelatihan K3 yang akan diberikan dapat berjalan efektif dan efisien serta dapat menjawab permasalahan terkait K3 di Laboratorium. Desain yang digunakan dalam penelitian ini adalah desain penelitian deskriptif kualitatif. Terdapat 8 informan yang diambil dari 6 Departemen-departemen preklinik FKUI. Metode pengambilan data dilakukan dengan mewawancarai 8 informan, observasi di Laboratorium dan telaah dokumen dari Laboratorium atau Departemen. Hasil dari penelitian ini menunjukkan bahwa organisasi telah mendukung pelaksanaan K3 di Laboratorium meskipun belum secara maksimal dan merata di semua Laboratorium. Terdapat 4 jenis tugas utama Laboran yaitu membantu praktikum mahasiswa, maintenance rutin alat, administrasi dan membantu penelitian Dosen atau Departemen serta sudah dapat menggambarkan jenis pelatihan yang dibutuhkan. Terkait aspek personal didapatkan bahwa pengetahuan dan keterampilan Laboran akan bahaya dan risiko yang ada di Laboratorium sudah cukup baik. Berdasarkan ketiga hal tersebut, pelatihan yang harus segera dilaksanakan adalah Chemical Hazards, Chemical Hygiene Plan, Develop Controls, General Laboratory Safety, Hazardous Materials, Job Safety Analysis, Laboratory Hygiene, Material Safety Data Sheet (MSDS), dan Safe Storage.

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Laboratory has a potential of occupational health and safety (OHS) hazards and risks because of the usage of hazardous materials and dangerous equipments. Laboratories of Faculty of Medicine University of Indonesia (FKUI) for instance use number of chemicals and biological materials and thus reduction of OHS risks is necessary. Training is one method of risk control by improving the OHS skills and the OHS knowledge of the workers. Prior to the training implementation, assessing the need of training is necessary.

Training needs analysis consists of three stages which are organizational, personal and task analysis. The purpose of this study was to analyze the need of OHS training for the Laboratory Assistants in order to have an effective and efficient training programs that can address the OHS related issues in the Laboratory. The research design was descriptive qualitative. There were 8 informants sampled from 6 FKUI preclinical Departments were interviewed . Observation and document analysis were also done to collect data.

The results of this study was shown that the organization has supported the OHS implementation in the Laboratories although not optimally and evenly distributed in all Laboratories. There were 4 Laboratory Assistant main types of tasks that consists of help students practice, routine maintenance tools, administration and assist Departments and Lecturer’s research and was able to describe the type of training required. Related to personal aspects obtained that Laboratory Assistant’s knowledge and skills about hazards and risks in the Laboratories were good enough. Based on those three, the training must be implemented was Chemical Hazards, Chemical Hygiene Plan, Develop Controls, General Laboratory Safety, Hazardous Materials, Job Safety Analysis, Laboratory Hygiene, Material Safety Data Sheet (MSDS) and Safe Storage."