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"Endocrinologists have engaged in thisnew method and have thus acquired many new and sophisticated tools. Withoutthese advances in molecular biological tools, could we have imagined, for example,that variants of the leptin receptor missing the part for signal transductionmight stillserve as a vehicle for leptin uptake through the blood–brain barrier? In this book, we aim to integrate such new results into an enhanced understanding of endocrinology."

"This book is a unique resource that will help pediatric radiologists, pediatricians, and pediatric endocrinologists to optimize the work-up and treatment of pediatric patients with endocrine disorders. Acclaimed experts in the field present and discuss the imaging findings obtained in disorders of the various endocrine systems, including the hypothalamo-pituitary axis, the thyroid and parathyroids, the adrenals, and the pancreas. Detailed advice is also provided on the assessment of bone growth and on imaging of the fetal glands, ambiguous genitalia, and the female pelvis in the context of precocious puberty. Throughout, care is taken to highlight characteristic findings and diagnostic clues. All of the currently used imaging techniques are covered, with clear explanation of their benefits and limitations. The informative text is supported by a wealth of high-quality illustrations, the large majority of them in color."

"Perawat Spesialis Medikal Bedah berperan penting dalam praktik keperawatan sebagai pemberi asuhan keperawatan kompleks, melakukan analisa ilmiah dan pembuktian ilmiah serta sebagai agen pembaharu. Melalui tulisan ini digambarkan pemberian asuhan keperawatan kepada pasien dengan diagnosis Chronic Limb Threatening Ischemia. Tujuan dari penulisan ini adalah memberikan gambaran praktek keperawatan spesialis medikal bedah menggunakan pendekatan Model Adaptasi Roy. Dari hasil pengumpulan data dan pemeriksaan fisik didapatkan 10 diagnosis keperawatan. Pemberian asuhan keperawatanpun dilakukan kepada 30 pasien sebagai kasus resume, diperoleh perilaku maladaptif pada mode fisiologis dengan diagnose terbanyak yaitu resiko infeksi dan nyeri kronik. Evidence Based Nursing dengan melakukan foot exercises kepada 8 pasien yang mengalami ulkus kaki diabetik dengan hasil yang signifikan terhadap perubahan ukuran luka. Program inovasi menerapkan Hypoglycemia-Nursing Early Warning Score System pada pasien diabetes melitus tipe 2 yang terbukti memudahkan perawat menilai resiko kejadian hipoglikemi berat selama 1 tahun. Pendekatan Model Adaptasi Roy berpengaruh besar terhadap profesi keperawatan. Model ini menjadi salah satu yang banyak digunakan dalam penelitian, pendidikan dan pelayanan keperawatan.

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Surgical Medical Specialist Nurses play an important role in nursing practice as a provider of advanced nursing care, conduct scientific analysis and scientific evidence and as a reforming agent. Through of this paper we describe the provision of nursing care to patients with a diagnosis of Chronic Limb Threatening Ischemia. The purpose of this paper is to provide an overview of the nursing practice of Surgical Medical Specialists using Roy's Adaptation Model approach. From the results of data collection and physical examination obtained 10 nursing diagnoses. In nursing care was provided to 30 patients as a case of resume, obtained maladaptive behavior in physiological mode with the most diagnoses, the risk of infection and chronic pain. Evidence Based Nursing by performing foot exercises on 8 patients who suffered diabetic foot ulcers with significant results on changes in wound size. The innovative program implementated the Hypoglycemia-Nursing Early Warning Score System in patients with type 2 diabetes mellitus which was proven to make it easier for nurses to assess the risk of severe hypoglycemic events for 1 year. Roy's Adaptation Model approach greatly influencing the nursing profession. This model is one that was widely used in research, education and nursing services"

"Endocrine disruption represents one of the most controversial environmental issues of our time. Mounting evidence stemming from more than 10 years of experimental, epidemiological and clinical studies has transformed the once generally discounted subject of endocrine disruptors into an issue of tremendous concern not only within the scientific community but among society as a whole. Following initial evidence from basic research, endocrine disruption in humans has now emerged as a major medical challenge. In this respect, puberty, a crucial developmental stage, has been definitively identified as a key window of vulnerability with regard to endocrine disruptors. Written by leading authorities in the field, Endocrine Disruptors and Puberty offers an engaging and comprehensive overview of this fascinating and rapidly growing problem. An indispensable resource for all clinicians and scientists interested in this challenging endocrinologic topic, Endocrine Disruptors and Puberty is a timely contribution that will help navigate a path toward understanding the problem and developing solutions. "

"Fibroblast growth factors (FGFs) have been recognized primarily as autocrine/paracrine factors that regulate embryonic development and organogenesis. However, recent studies have revealed that some FGFs function as endocrine factors and regulate various metabolic processes in adulthood. Such FGFs, collectively called endocrine FGFs, are comprised of three members (FGF15/19, FGF21, and FGF23: FGF15 is the mouse ortholog of human FGF19). These endocrine FGFs share a common structural feature that enables the endocrine mode of action at the expense of the affinity to FGF receptors. To restore the affinity to FGF receptors in their target organs, the endocrine FGFs have designated the Klotho family of transmembrane proteins as obligate co-receptors. By expressing Klothos in a tissue-specific manner, this unique co-receptor system also enables the endocrine FGFs to specify their target organs among many tissues that express FGF receptors."

"Program residensi keperawatan medikal bedah peminatan endokrin adalah program meningkatkan kemampuan perawat spesialis yang kompeten dalam memberikan asuhan keperawatan pada pasien dengan gangguan sistem endokrin. Gangguan sistem endokrin yang paling banyak di pelayanan kesehatan adalah Diabetes melitus (DM). Kadar glukosa darah yang tidak terkontrol akan menimbulkan berbagai komplikasi baik akut maupun kronis. Dibutuhkan pendekatan dari berbagai sistem ilmu untuk memberikan penanganan dan pencegahan komplikasi pada pasien DM. Perawat Spesialis mampu memberikan asuhan keperawatan yang holistik dengan tujuan pasien DM mampu mengontrol gula darah dan beradaptasi dengan penyakitnya. Model Adaptasi Roy dapat digunakan sebagai acuan dalam memberikan asuhan keperawatan yang holistik dan komprehensif dengan mengubah perilaku yang tidak efektif menjadi efektif. Penerapan praktek keperawatan berbasis pembuktian (evidence based practice) dilakukan tindakan electrical stimulation sebagai acuan intervensi keperawatan pada pasien DM tipe 2 untuk menurunkan kadar gula darah. Program inovasi dilakukan dalam bentuk penerapan edukasi menggunakan media booklet sebagai pedoman dalam manajemen diabetes mellitus.

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ABSTRACT Name : Noor Diani Program : Medical Surgical Nursing Specialist Program Faculty of Nursing University of Indonesia Title : Practical Analysis on Residency of Medical Surgical Nursing Focusing on Patient with Endocrine System Disturbance using Roy Adaptation Theory in Fatmawati Hospital Jakarta The purpose of residency practice on medical surgical nursing focusing in patient with endocrine system disturbance is to enhance the competencies of specialist student in giving nursing care patient in advance level. Diabetes Mellitus (DM) is the most common case in patient with endocrine system disturbance. Uncontrolled blood sugar levels in DM patient create acute and/or chronic complications. It is needed multidiscipline approach to care and prevent DM complications. Medical surgical nursing specialist has to able to give nursing care to DM patient with the purpose of enable patient to control their blood sugar level and adjusting with their disease. Roy adaptation model can be used as guidance in giving holistic and comprehensive nursing care to DM patient by changing their behavior from unhealthy to healthy life style. The evidence based practice that had been applied was electrical stimulation in reducing blood sugar level in DM patient, and the innovation was applying booklet as education media for DM patient management. Keywords: nurse specialist, diabetes mellitus, Roy Adaptation Model, electrical stimulation, booklet as education media."

"Penyakit endokrin merupakan penyebab kematian dengan angka yang cukup tinggi baik secara nasional maupun global. Hal ini menjadi tantangan bagi seluruh tenaga kesehatan khususnya bagi perawat spesialis medikal bedah peminatan endokrin dalam ikut membantu menurunkan tingkat komplikasi yang terjadi. Praktik ilmu keperawatan yang berkualitas berdasarkan evidence base nursing terbaru menjadi landasan dalam melaksanakan peran sebagai pemberi asuhan, peneliti, pendidik dan inovator. Praktik residensi perawat spesialis peminatan endokrin berlangsung dalam dua semester telah memberikan pengalaman dan kesempatan untuk menerapkan teori keperawatan secara menyeluruh dalam mengelola asuhan kepada pasien. Penerapan model teori adaptasi Roy dilakukan oleh residen terhadap 30 kasus resume dan satu kasus kelolaan utama yaitu pada pasien Diabetes Melitus type 2 dengan riwayat KAD, akut on CKD, hipertensi, dyslipidemia dan pankreatitis akut. Peran peneliti dilakukan dengan menerapkan evidence base nursing yaitu melalui inlows sixty second sebagai alat screening risiko terjadinya luka kaki pada pasien Diabetes Melitus. Inovasi pelayanan yang dilakukan residen adalah membuat alat simulation tool yaitu alat edukasi untuk pasien Diabetes Melitus yang menerima terapi insulin pertama kali. Protokol ini mampu memberikan panduan secara sistematis, mudah dipahami, serta mudah dilaksanakan oleh perawat kepada pasien sehingga diharapkan pasien dengan terapi insulin tidak merasa ketakutan saat mendapatkan insulin pertama kali.

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Endocrine disease is a cause of death with a fairly high number both nationally and globally. This is a challenge for all health workers, especially for medical surgical specialist nurses specializing in endocrine in helping to reduce the rate of complications that occur. Quality nursing science practice based on the latest nursing evidence base is the cornerstone in carrying out the role as a caregiver, researcher, educator and innovator. The endocrine specialist nurse residency practice which takes place over two semesters has provided experience and opportunity to apply nursing theory as a whole in managing care for patients. Residents applied Roy's adaptation theory model to 30 resume cases and one main managed case, namely type 2 Diabetes Melitus patients with a history of DKA, acute CKD, hypertension, dyslipidemia and acute pancreatitis. The role of the researcher is carried out by applying evidence-based nursing, namely through sixty second inlows as a screening tool for the risk of foot injuries in patients with Diabetes Melitus. The resident's service innovation is to make a simulation tool, which is an educational tool for Diabetes Melitus patients who receive insulin therapy for the first time. This protocol is able to provide guidance in a systematic, easy to understand, and easily implemented by nurses to patients so that patients on insulin therapy are expected not to feel afraid when they get insulin for the first time."