Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang. Sindrom nefrotik (SN) merupakan penyakit ginjal yang sering ditemukan pada anak. Komplikasi SN terkait perjalanan penyakit, terapi, fisik dan psikososial yang memengaruhi kualitas hidup. Tujuan. Mendapatkan gambaran tentang kualitas hidup anak SN yang berobat di Departemen Ilmu Kesehatan Anak (IKA) Rumah Sakit Dr. Cipto Mangunkusumo (RSCM) dan faktor yang berhubungan. Metode. Studi deskriptif analitik dengan desain potong lintang di poliklinik nefrologi dan rawat inap Departemen IKA RSCM periode April 2012 - Desember 2013. Subjek berusia 2-18 tahun. Penilaian kualitas hidup menggunakan PedsQLTM 4.0 modul generik dan pola asuh menggunakan Kuesioner Pola Asuh Anak (KPAA). Hasil. Seratus pasien SN mengikuti penelitian dan didapatkan gangguan kualitas hidup berdasarkan laporan orangtua dan laporan anak 19%. Usia 5-7 tahun, usia 13-18 tahun, status sosioekonomi rendah, dan kondisi relaps jarang pada SN sensitif steroid (SNSS) merupakan faktor risiko gangguan kualitas hidup pada laporan orangtua (p<0,05) dengan rasio prevalens secara berurutan 5,22, 7,5, 3,48, 10,33. Penggunaan steroid saat penelitian memiliki hubungan dengan kualitas hidup berdasarkan laporan orangtua (p<0,05). Tingkat pendidikan ayah yang semakin rendah merupakan faktor risiko gangguan kualitas hidup pada laporan anak (p<0,05) dengan rasio prevalens 5,22. Lama diagnosis memiliki hubungan dengan kualitas hidup pada laporan orangtua dan anak (p<0,05). Status sosioekonomi dan pola asuh merupakan faktor risiko gangguan kualitas hidup. Simpulan. Usia prasekolah, remaja, kondisi relaps jarang, penggunaan steroid, lama diagnosis, tingkat pendidikan ayah semakin rendah, status sosioekonomi dan pola asuh akan memengaruhi kualitas hidup anak SN. Gangguan kualitas hidup pada pasien SN merupakan masalah yang perlu diperhatikan dalam tata laksana.

---

Background. Nephrotic syndrome (NS) is the most common kidney disease in children. Complication of NS is associated with course of disease, therapy, and psychosocial condition affecting the quality of life (QoL).

Aim. Describing the QoL in children with NS and its associated factors in pediatric outpatient clinic and ward in Dr. Cipto Mangunkusumo Hospital.

Method. Cross sectional study was performed in pediatric nephrology clinic and ward in Dr. Cipto Mangunkusumo Hospital, from April 2012 to December 2013. Subjects were 2 to 18 years old. Quality of life was assessed using PedsQLTM 4.0 generic module and parenting style was assessed with Kuesioner Pola Asuh Anak.

Results. One hundred subjects participated in this study and QoL impairment was reported in 19% subjects based on report from parents and children. Factors associated with impairment QoL from parent's report were age group 5 - 7 years old, age group 13 - 18 years old, low socioeconomic status, and infrequent relapse condition in steroid sensitive NS (P<0.05), with prevalence ratio 5.22, 7.5, 3.48, 10.33, respectively. Steroid use was also associated with QoL according to parent’s report (P<0,05). Lower father's education was risk factor for QoL impairment according to patient's report (P<0,05) with prevalence ratio 5.22. Duration of diagnosis was associated with QoL according to parent’s and patient’s report (P<0,05). Socioeconomic status and parenting style were risk factors of QoL impairment in children with NS.

Conclusion. Preschool age, teen age, infrequent relapse, steroid use, duration of diagnosis, low father’s education, socioeconomic status, and parenting style are associated with QoL in children with NS. Quality of life impairment is important in management of children with NS. "

"Latar belakang. Air susu ibu ASI merupakan nutrisi ideal bagi seorang bayi, namunkomposisi ASI bervariasi dan sangat individual. Human milk fortifier HMF direkomendasikan oleh WHO untuk diberikan pada bayi sangat prematur dan/atau bayiberat lahir sangat rendah BBLSR , namun belum terdapat kesepakatan kapan waktumemulainya. Selain itu kelompok ini berisiko mengalami kekurangan atau kelebihan zatbesi akibat pemberian suplementasi besi rutin. Objektif. Mendapatkan profil perubahan kandungan energi makronutrien dan zat besi dariASI bayi sangat prematur dan/atau BBLSR, serta kecukupan kandungan nutrisi dan zat besipada ASI untuk memenuhi kebutuhan yang direkomendasikan.Metode. Studi deskriptif analitik dengan desain multiple measurement pada studilongitudinal. Sampel penelitian adalah ASI ibu yang melahirkan bayi sangat prematurdan/atau BBLSR periode bulan Juli-Oktober 2017 di unit perinatologi RSCM. PemeriksaanASI menggunakan MIRIS dilakukan secara serial selama 4 minggu dan pada minggu 4dilakukan pemeriksaan kadar besi ASI menggunakan ICP-MS. Sebanyak 30 ibu yang memiliki data lengkap hingga minggu 4 dilakukan analisis.Hasil. Terdapat penurunan kandungan protein di ASI p=0,0003 disertai peningkatanlemak p=0,0004 dan kalori p=0,0006 setiap minggunya, namun tidak demikian dengankarbohidrat p=0,447 . Kekurangan protein di ASI didapatkan sejak minggu II pascakelahiran walaupun kalori lemak ASI masih mencukupi. Kadar zat besi ASI pada hari 28ditemukan lebih rendah dari nilai rekomendasi ESPGHAN dan AAP-Con ditemukan padapemeriksaan hari ke 28.Kesimpulan. Terdapat perubahan kandungan makronutrien setiap minggunya pada ASIbayi sangat prematur dan/atau BBLSR dan tidak mencukupi kebutuhan yang direkomendasikan. Pemberian HMF dapat dipertimbangkan untuk diberikan sejak minggu IIuntuk mencukupi kebutuhan tumbuh kejar.

---

Background. Mother rsquo s own milk MOM is an ideal nutrition for a baby, but thecomposition is varied and highly individualized. Human milk fortifier HMF is recommended by WHO for very premature infants and or very low birth weight VLBW infants, yet no agreement when to start. In addition, this group is at risk of iron deficiencyor excess due to routine iron supplementation.Objective. To find the changes in macronutrient and iron contents from MOM in verypremature infants and or VLBW infants, as well as the adequacy of nutrients and ironcontents in MOM to conform recommended needs.Method. Analytical descriptive study with multiple measurement design in longitudinalstudy. Subjects were mothers who delivered very premature infants and or VLBW infantsfrom July to October 2017. Breast milk was serialized with MIRIS for 4 weeks and ironcontent was researched with ICP MS at 4th week. The study took place in neonatolgy unitin Cipto Mangunkusumo Hospital. A total of 30 mothers who had complete data for 4weeks were analyzed.Results. There was a decrease in protein content in breast milk p 0.0003 and increasedfat p 0.0004 and calories p 0.0006 per week, but not in carbohydrates p 0.447 .Although this result is higher than the study of systematic review in Australia in 2016.Protein deficiency in breast milk was found from the first week after birth and iron contentis lower than the value of recommendation of ESPGHAN and AAP Con at 28 dayexamination.Conclusion. Macronutrient content changes each week in breast milk of very prematureand or VLBW infants and not enough from dietary recommendation. Giving HMF may beconsidered at 1st week after birth."

"Respiratory Distress Syndrome (RDS), Feeding Intolerance (FI), dan sepsis merupakan morbiditas yang sering dialami bayi prematur. Salah satu faktor yang memengaruhi morbiditas adalah defisiensi vitamin D. Kadar vitamin D berkorelasi dengan sel Treg pada penyakit inflamasi bayi baru lahir. Sel Treg berperan dalam keseimbangan mikrobiota di usus. Tujuan penelitian ini untuk mengetahui peran vitamin D dengan kejadian RDS, FI, dan sepsis pada bayi sangat prematur dan/atau BBLSR melalui jalur sel Treg dan disbiosis usus. Design penelitian ini adalah kohort prospektif pada bayi sangat prematur dan/atau BBLSR, dilakukan bulan November 2019–Januari 2021 di Unit Neonatal RSCM. Pemeriksaan kadar vitamin D ibu dan bayi menggunakan metode CLIA dan Treg dengan flow cytometry menggunakan Treg detection kit CD4+CD127lowCD25+. Penilaian mikrobiota dengan Real Time PCR dan enteropati dengan Alpha-1 Antitrypsin. Pada penelitian ini didapatkan sebesar 88,3 % ibu defisiensi vitamin D (rerata 12,23 ± 5,07 ng/mL) dan 53% bayi defisiensi vitamin D (rerata 15,79  6,9 ng/mL). Didapatkan korelasi antara kadar vitamin D ibu dan bayi (r = 0,76, p < 0,001). Kadar vitamin ibu dan bayi tidak berhubungan dengan dengan kejadian RDS, FI, dan sepsis. Terdapat hubungan bermakna antara disregulasi sel Treg dengan kejadian FI (p = 0,04) dan sepsis (p = 0,03). Semua bayi mengalami disbiosis. Tidak didapatkan perbedaan komposisi mikrobiota pada RDS, FI, dan sepsis. Terdapat hubungan bermakna antara enteropati dengan kejadian sepsis (p = 0,02). Simpulan : Ibu defisiensi vitamin D akan melahirkan bayi defisiensi vitamin D. Kadar vitamin D tidak berpengaruh terhadap kejadian RDS, FI, dan sepsis. Pada bayi dengan disregulasi sel Treg, kejadian FI dan sepsis lebih tinggi dibandingkan yang tidak. Bayi dengan kondisi disbiosis tidak berbeda untuk terjadinya RDS, FI, dan sepsis. Kondisi enteropati menyebabkan kejadian sepsis lebih tinggi.

---

Respiratory distress syndrome, feeding intolerance, and sepsis are the most common morbidities found in premature babies. One of the factors affecting morbidity is vitamin D level. Vitamin D level is correlated with the role of Treg cells in inflammatory neonatal. Treg cells act in balancing microbiota in the intestines. This study aimed to determine the role of vitamin D in increasing the incidence of sepsis, feeding intolerance, and respiratory distress syndrome in very premature and/or very low birth weight babies through Treg cells and intestinal dysbiosis. This is a cohort study conducted on very premature (< 32 weeks) and/or very low birth weight (birth weight < 1,500 g) babies, from November 2019–January 2021 in the Neonatal Unit of RSCM. Vitamin D levels of the mothers and babies were measured using the CLIA and Treg methods with flow cytometry using the Treg detection kit CD4+CD127lowCD25+. Treg was tested from umbilical cords blood. The fecal examination was conducted to determine intestinal bacteria using realtime PCR and Alpha-1 Antitrypsin. Most mothers (88.3%) had vitamin D deficiency with a mean value of 12.33 ± 5.07 ng/mL. The vitamin D level of the umbilical cord was 15.79 ± 6.9 ng/mL. There was a significant correlation between the vitamin D level of mothers and babies (r = 0.76, p < 0.001). There were no difference between maternal and babies vitamin D serum levels with incidence of RDS, FI, and sepsis.There were a significant correlation between Treg cell dysregulation and the incidence of FI (p = 0.04) and sepsis (p = 0.03) but not in RDS. All subjects experienced dysbiosis. There was a significant correlation between enteropathy and the incidence of sepsis (p = 0.02) but not in RDS and FI. Conclusion: Mothers with vitamin D deficiency will give birth to babies with vitamin D deficiency. There were no correlation between vitamin D and the incidence of RDS, FI, and sepsis. In babies with Treg cell dysregulation, the incidence of feeding intolerance and sepsis will be higher. The composition of the microbiota did not affect the incidence of RDS, FI, sepsis. In babies with enteropathy, the incidence of sepsis will be higher."