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"Pendahuluan dan tujuan: Gangguan traktus urinarius pada pasien pediatrik merupakan kasus yang kompleks, karena itu membutuhkan evaluasi yang cukup lengkap. Videourodinamik (VUD) adalah sebuah pemeriksaan yang baik, yang dapat memberikan hasil evaluasi gabungan dari sistouretrografi flouroskopi dan evaluasi tekanan, aliran, dan elektromiografi dari traktus urinarius bagian bawah. Karenanya, saat ini VUD menjadi pemeriksaan yang standar untuk evaluasi gangguan traktus urinarius bagian bawah. Penelitian ini bertujuan untuk melihat profil pasien urologi di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo (RSCM) selama 5 tahun yang dilakukan pemeriksaan VUD. Metode: Penelitian ini merupakan penelitian retrospektif terhadap semua pasien pediatri (<18 tahun) yang menjalani pemeriksaan VUD dari tahun 2014 hingga 2019 di RSCM. Hasil dari pemeriksaan VUD diambil dari 3 fase pemeriksaan VUD yaitu fase pengisian, miksi, dan pasca miksi. Perbandingan antar variabel dari hasil pemeriksaan VUD dilakukan antara dua kelompok yaitu kelompok pasien dengan gangguan traktus urinarius bawah neurogenik (NLUTD) dan gangguan traktus urinarius bawah non-neurogenik. Selain itu penelitian ini juga melihat hubungan antara kondisi pasien yang menjadi indikasi pemeriksaan VUD dengan insidensi terjadinya gagal ginjal kronik pada pasien. Hasil: Ada 68 subjek yang diteliti pada penelitian ini. Diagnosis klinis tersering sebagai indikasi dilakukan pemeriksaan VUD adalah refluks vesikoureter (n=31; 45.6%); dan buli neurogenik (n=26; 38.8%). Penelitian ini menemukan bahwa dalam perbandingan pasien NLUTD dengan NNLUTD, penurunan bladder compliance dan penampakan Christmas-tree ditemukan lebih banyak secara signifikan pada kelompok NLUTD (p<0.001, p=0.008). Penelitian ini tidak menemukan korelasi signifikan antara kondisi-kondisi sebagai indikasi pemeriksaan VUD dengan angka insidensi gagal ginjal kronis. Kesimpulan: Penelitian ini menemukan bahwa refluks vesikoureter dan buli neurogenik merupakan gangguan yang paling sering menyebabkan pasien melakukan pemeriksaan VUD. Selain itu penurunan bladder compliance dan penampakan Christmas-tree ditemukan lebih banyak secara signifikan pada kelompok NLUTD. Penelitian lebih lanjut dibutuhkan untuk melihat adanya korelasi antara kondisi-kondisi sebagai indikasi pemeriksaan VUD dengan angka insidensi gagal ginjal kronis.

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Introduction and Objectives: Compared to adults, urinary tract disorders in infants and children are more complex. Therefore a thoroughly evaluation is needed in pediatric patients. Videourodynamic (VUD) provides a combination of cystourethrographic fluoroscopic examination with evaluation of pressure, flow, and electromyography of the lower urinary tract. Thus it is now the standard examination carried out in the evaluation of lower urinary tract disorders. This study aim to determine a five-year profile of videourodynamic examinations in pediatric urology patients at RSUPN Dr. Cipto Mangunkusumo (RSCM). Method: This study wasa retrospective study in all pediatric patients (<18 years) who underwent VUD examination from January 2014 to December 2019 using secondary data medical record. VUD findings collected from 3 phases of VUD, that is filling, voiding, and post-void phase. Comparison of variables was done between the neurogenic lower urinary tract dysfunction (NLUTD) group and non-neurogenic lower urinary tract dysfunction (NNLUTD) group.This study also looked for correlation between VUD indications in subjects and the chronic kidney disease (CKD) incidence. Results: There were 68 pediatric patients, as subjects of the study. The most prevalent clinical diagnosis found as indication for VUD examination was vesicoureteral reflux (n=31; 45.6%); and neurogenic bladder (n=26; 38.8%). This Study found that in comparison with NNLUTD patients, reduced bladder compliance and Christmas-tree appearance found significantly more in NLUTD patients (p<0.001, p=0.008). We found no significant correlation between indication for VUD examination and CKD incidence. Conclusion: This study found that vesico-ureteric reflux and neurogenic bladder is the two most common abnormalities found in pediatric urology who underwent VUD examination. Reduced bladder compliance and Christmas-tree appearance found to be significantly more prevalent in pediatric NLUTD patients compared to NNLUTD patients. Further studies are required regarding bladder shape in NLUTD patients and to see a correlation between indication for VUD examination and the risk of CKD."

"Extensively revised and updated, this book provides support to primary care physicians through its review of common genitourinary problems. This edition continues to provide the primary care physician with tools to better recognize urological diseases as well as updated management strategies for these disorders. To enhance the theme of comprehensive care and family medicine, the volume is formatted according to the life cycle and the urological challenges, which may be detected and diagnosed by primary care physicians respective of the patient’s stage in life, beginning with pregnancy and in utero diagnoses. Pediatric themes such as infection and voiding dysfunctions are followed by adult urological topics ranging from prostate diseases, nephrolithiasis, overactive bladder syndromes, incontinence and urological cancer screening. Three new chapters are added addressing male infertility/andrology and the growing demand for integrative and alternative medical care of urologic patients, as well as commonly encountered dermatological problems in the genital area."

"Pendahuluan: Penelitian ini bertujuan mendapatkan profil pasien adenokarsinoma buli secara komprehensif di Rumah Sakit Cipto Mangunkusumo dari tahun 1995-2012.Metode: Studi ini menggunakan rancangan deskriptif potong lintang. Data sekunder dikumpulkan secara retrospektif dari rekam medis Departemen Urologi Rumah Sakit Cipto Mangunkusumo dari tanggal 1 Januari 1995 - 31 Desember 2012. Pasien dengan adenokarsinoma buli dikategorikan menggunakan stadium berdasarkan sistem TNM/AJCC 2010. CT scan dilakukan untuk penentuan stadium adenokarsinoma buli.Hasil: Terdapat 45 pasien, yang terdiri dari 12 (26,7%) wanita dan 33 (73,3%) laki-laki. Umur rerata pasien adalah 46.04±13,50 (18-72) tahun. Riwayat batu buli ditemukan pada 11 (24,4%) dari total 45 pasien. Pada umumnya pasien didiagnosis pada stadium IV dan hanya sebagian kecil yang didiagnosis pada stadium I. Terdapat 16 (35,5%) pasien dengan metastase pada awal didiagnosis. Pada umumnya, (64,4%) pasien hanya dilakukan TUR-BT. Sebelas (24%) pasien dilakukan tindakan sistektomi. Pasien lainnya juga diberikan radioterapi (6,7%) dan kemoterapi (4,4%).Kesimpulan: Insiden adenokarsinoma buli pada penelitian ini ditemukan lebih tinggi dibandingkan penelitian sebelumnya di negara-negara berkembang lainnya. Beberapa karakteristik pasien dengan adenokarsinoma buli di Rumah Sakit Cipto Mangunkusumo memiliki kesamaan dengan negara lain dalam hal jenis kelamin yang dominan, penentuan stadium pada saat ditegakkan diagnosis, dan jenis operasi yang dilakukan. Usia pasien saat pertama kali didiagnosis adenokarsinoma buli di Indonesia pada umumnya lebih muda dan seperempat dari total pasien memiliki riwayat batu buli.

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Introduction: The aim of this study was to get a comprehensive profile of bladder adenocarcinoma patient at "CiptoMangunkusumo" Hospital from 1995 to 2012.

Method: This was a descriptive cross-sectional study. Secondary data were obtained retrospectively from Departement of Urology,"CiptoMangunkusumo" Hospital medical record from 1st January 1995 to 31st December 2012. Staging of bladder adenocarcinoma patients were based on TNM/AJCC 2010. CT scan was performed as staging procedure of bladder adenocarcinoma.

Results: There were 45 patients which were 12 female (26,7%) and 33 male (73.3%). Mean of subjects?s age (n=45) was 46.04±13,50 (18-72) years old. History of bladder stone was found in 11 of 45 patients (24,4%). Most patients were diagnosed at stage IV and only small percentage were diagnosed at stage I. There were 16 patients (35,5%) with metastases at time of first diagnosis. Most of our patients (64.4%) were treated with TUR-BT only. Eleven (24%) patients were treated with cystectomy. The rest of the patient was performed radiotherapy (6,7%) and chemotherapy(4,4%).

Conclusion: Several characteristics of bladder adenocarcinoma patients in "Cipto Mangunkusumo" Hospital are similar with studies in other countries in parts of gender predominant, staging at first diagnosed, and type of surgery performed. Age at first diagnosed with bladder adenocarcinoma tend to be younger in Indonesia, and one fourth of our patients presented with history of bladder stone."

"Praktek klinik lanjut selama praktek residensi keperawatan pada sistem Urologi bertujuan agardapat memberikan asuhan keperawatan, menerapkan Evidence Based Nursing (EBN) serta mampu berperan sebagai innovator di ruang perawatan. Peran pemberi asuhan keperawatan dilakukan dengan menggunakan model adaptasi Roy pada pasien dengan Karsinoma Ginjaldan 30 pasien lainnya dengan berbagai gangguan sistem urologi. Perilaku maladaptif paling banyak adalah mode adaptasi fisiologi, yaitu kelebihan volume cairan. Intervensi keperawatan berupa manajemen keseimbangan cairan untuk meningkatkan adaptasi pasien dalam keseimbangan cairan. Penerapan EBN dengan music intradialytic pada tiga pasien hemodialisis menunjukkan keefektifan musik intradialytic dalam menurunkan tingkat kecemasan. Program inovasi keperawatan berupa penerapan program peningkatan adekuasi hemodialisis pada pasien ESRD di Instalasi Hemodialisis.

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Advanced clinical practice during nursing residency practice in the Urology system aims to provide nursing care, implement Evidence Based Nursing (EBN) and be able to act as an

innovator in the nursing center. The role of the nursing care provider was performed using

Roy's adaptation model in patients with Renal Carcinoma and 30 other patients with various urological system disorders. The most inefektive behavior is the physiological adaptation mode, which is excess fluid volume. Nursing interventions take the form of fluid balance management to improve patient adaptation in fluid balance. The application of EBN with intradialytic music in six patients undergoing hemodialysis therapy demonstrated the effectiveness of music in reducing anxiety levels. The nursing innovation program is in the form of implementing a hemodialysis adequacy program in ESRD patients at the Hemodialysis Installation."

"Images in urology is a unique book that integrates images of urological conditions within their clinical context. Improvements in imaging techniques have meant greater diagnostic power and a dramatic rise in the number and quality of images obtained and viewed by practicing clinicians. None more so than in the field of urology, where static and dynamic images are fundamental to the diagnosis and treatment of almost all conditions. This book presents images of radiological and radionucleotide scans, macroscopic and microscopic histopathology specimens, urodynamic traces and photographs of dermatological conditions relating to urology. Each section has a series of questions, often relating to a clinical scenario, about the images. A comprehensive answer provides a description of each image and of the condition shown. Details of how to interpret the image and the use of contrast or staining methods to help differentiate normal anatomy from pathology are included. Images in Urology is an essential tool for urology, radiology and histopathology trainees and consultants, as well as being an excellent exam preparation guide."

"Peran NT-proBNP sebagai penanda biologis untuk mengetahui terjadinya sindrom curah jantung rendah pada pasien pediatrik dengan penyakit jantung bawaan sianotik pascabedah jantung terbuka belumlah diketahui. NT-proBNP diharapkan dapat menjadi penanda sindrom curah jantung rendah sehingga dapat mengurangi morbiditas dan mortalitas. Penelitian cross sectional ini melibatkan 40 pasien pediatrik dengan penyakit jantung bawaan sianotik yang menjalani pembedahan jantung terbuka di Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita, selama bulan Maret 2019-April 2019. Terdapat perbedaan bermakna antara kadar NT-proBNP prabedah, 4 jam pascabedah, 24 jam pascabedah dan 72 jam pascabedah terhadap kejadian sindrom curah jantung rendah (p<0,001). Kadar NT-proBNP tertinggi pada 24 jam pasca bedah dengan perbedaan bermakna terhadap kadar NT-proBNP prabedah (p<0,001), 4 jam pascabedah dan 72 jam pascabedah (p<0,001). Diperoleh pula variabel lain yang berhubungan secara bermakna dengan NT-proBNP yaitu usia, berat badan, jenis penyakit jantung bawaan sianotik, lama aortic cross clamp, lama cardiopulmonary bypass, lama ventilasi mekanik dan lama rawat PICU. Dapat disimpulkan bahwa kadar NT-proBNP yang tinggi sebagai penanda kejadian sindrom curah jantung rendah.

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The role of NT-proBNP as a biological marker to determined the occurrence of low cardiac output syndromes in pediatric patients with cyanotic congenital heart disease after open heart surgery was unknown. NT-proBNP was expected to be a marker of low cardiac output syndrome so that it can reduce morbidity and mortality. This cross-sectional study involved 40 pediatric patients with cyanotic congenital heart disease who underwent open heart surgery at National Cardiovascular Centre Harapan Kita, during March 2019-April 2019. There were significant differences between pre-operative levels of NT-proBNP, 4 hours postoperatively, 24 hours postoperatively and 72 hours postoperatively with the incidence of low cardiac output syndrome (p <0.001). The highest NT-proBNP level was 24 hours postoperatively with a significant difference in preoperative levels of NT-proBNP (p <0.001), 4 hours postoperatively and 72 hours postoperatively (p <0.001). Other variables that were significantly associated with NT-proBNP were age, body weight, type of cyanotic congenital heart disease, duration of aortic cross clamp, duration of cardiopulmonary bypass, duration of mechanical ventilation and length of stay of PICU. It can be concluded that high NT-proBNP level as a marker of low cardiac output syndrome."

"System requirements: Windows 2000, XP, Vista; Intel Pentium III processor (or equivalent) /​ 750 MHz or greater (may be sluggish with processor speeds below 800 MHz) ; 256 MB or more of installed RAM ; 16X or faster CD-ROM drive ; At least an 800 x 600 pixels screen resolution ; Highest color quality (32-bit)System requirements: MAC OS 10.3 or higher; 666 MHz PowerPC or greater (may be sluggish with processor speeds below 750 MHz) ; 256 MB or more of installed RAM ; 16x or faster CD-ROM drive ; 800 x 600 monitor or larger ; Millions of Colors display recommended"

"Pengurangan risiko jatuh merupakan bagian dari standar sasaran keselamatan pasien yang harus diperhatikan. Untuk mengurangi risiko jatuh di rumah sakit dilakukan penilaian risiko jatuh, pada pasien anak rawat inap menggunakan instrumen penilaian Humpty Dumpty Fall Scale (HDFS) Penelitian ini bertujuan mengidentifikasi gambaran tingkat risiko jatuh pada anak yang dirawat di rumah sakit. Desain penelitian ini adalah deskriptif dengan pendekatan potong lintang. Sampel 104 responden diambil dengan menggunakan teknik simple random sampling. Data yang dikumpulkan didapat dari catatan rekam medik pasien. Hasil penelitian menunjukkan gambaran tingkat risiko jatuh tinggi menurut karakteristik pasien anak yaitu pasien anak usia toddler (44,6%), bayi (26,8%), dan anak usia prasekolah (14,3%), laki-laki (66,1%), diagnosis medis dengan perubahan oksigenasi (39,3%) dan gangguan neurologis (28,6%), dan anak yang menggunakan obat penenang (32,1%). Penelitian ini merekomendasikan perlu dilakukan penelitian lebih lanjut mengenai pencegahan, pengetahuan, sikap dan perilaku perawat terkait dengan tingkat risiko jatuh.

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Reduction of the risk of falling is part of the standard of patient safety goals that have to be considered. To reduce the risk of falls in hospital using falling risk assessment, pediatric patients hospitalized use instruments Humpty Dumpty Fall Scale (HDFS). The aimed of this study was to identify the level of the risk of falls in chidren inpatient. The research design was a descriptive cross sectional. The sample of this study was 104 respondents who were selected with a simple random sampling technique. Data were collected using a patient medical record. The result showed a high level of the risk of falling by the characteristic of pediatric patients in which patients were children aged toddler (44.6%), infant (26.8%), and preschoolers (14.3%), male (66.1%), medical diagnosis with changes in oxygenation (39.3%) and neurogical disorders (28,6%), and children who use drugs tranquilizers (32.1%). The study recommends further research needs to be study on prevention, knowledge, attitudes and behavior of nurses associated with the risk level falls."

"Latar belakang: Perdarahan sendi berulang merupakan morbiditas utama pada pasien hemofilia karena dapat menimbulkan artropati hemofilik yang menyebabkan keterbatasan gerak dan disabilitas sehingga menurunkan kualitas hidup. Penelitian bertujuan mengetahui korelasi pemeriksaan klinis sendi, penilaian aktivitas fungsional dan kualitas hidup pada anak hemofilia.Metode: Penelitian dengan desain potong lintang di RSCM pada Agustus−November 2022 pada anak 4−16 tahun, hemofilia A atau B derajat sedang atau berat yang mengalami perdarahan sendi berulang. Penelitian dilakukan dengan menilai HJHS, PedHALshort serta Haemo-QoL dan mencari korelasi skor HJHS dengan skor PedHALshort dan Haemo-QoL.Hasil: Sebanyak 95 subyek hemofilia, dengan hemofilia A (77,3%) dan 70,1% hemofilia berat. Skor HJHS median 4 (1−9), skor PedHALshort median 74,5 (62,73-89,09), skor Haemo-QoL mean (SD) 74,51 (15,58). Skor HJHS berkorelasi negatif sedang dengan PedHALshort (r= -0,462, p< 0,0001), skor HJHS berkorelasi sedang dengan Haemo-QoL (r= 0,469, p< 0,001).Simpulan: Semakin tinggi skor HJHS menunjukkan adanya kerusakan pada sendi maka semakin rendah skor PedHALshort dan semakin tinggi skor Haemo-QoL yang menunjukkan semakin terganggu aktivitas fungsional serta kualitas hidupnya.

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Background: Recurrent joint bleeding is the major morbidity in patient with hemophilia that can cause hemophilic arthropathy causes limitation of daily activities, disability, and reducing quality of life. Research objective are to determine the relationship between the clinical evaluation of joints, the assessment of functional activity determined and assessment of the quality of life with HJHS, so we can diagnose arthropathy, prevent disability and better management.

Methods: Study with cross-sectional design at RSCM on August-November 2022, children aged 4-16, with moderate or severe hemophilia A and B with recurrent joint bleeding. The study was conducted by assessing HJHS, PedHALshort and Haemo-QoL, determine the relationship between HJHS with PedHALshort and Haemo-QoL score.

Result: A total of 95 hemophilia subjects, with hemophilia A (77.3%) and 70.1% severe hemophilia. HJHS median score 4 (1-9), PedHALshort median score 74.5 (62.73-89.09), Haemo-QoL mean (SD) 74.51 (15.58). The HJHS score had a moderate negative correlation with PedHALshort (r= -0.462, p<0.0001), the HJHS score had a moderate correlation with Haemo-QoL (r= 0.469, p<0.001).

Conclusion: The higher of HJHS score indicates a joint disorder, the lower of PedHALshort and the higher of Haemo-QoL indicates the more impaired functional activity and poorer quality of life."