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"Leukemia adalah salah satu jenis kanker yang paling banyak ditemukan pada masyarakat perkotaan khususnya pada anak-anak. Tujuan karya ilmiah ini adalah untuk mendeskripsikan asuhan keperawatan pada anak yang menderita leukemia dan optimalisasi perawatan mulut pasca kemoterapi. Berdasarkan pengkajian yang dilakukan pada kasus kelolaan yang terdiagnosis leukemia limfoblastik akut (ALL), didapatkan prioritas masalah keperawatan yaitu ketidakefektifan bersihan jalan napas, kerusakan membran mukosa oral, risiko cedera, dan risiko kekurangan volume cairan. Hasil evaluasi asuhan keperawatan didapatkan bahwa penerapan perawatan mulut berupa menggosok gigi dan berkumur-kumur dengan normal salin (NaCl 0.9%). Perawatan mulut secara teratur dengan normal salin sangat efektif dilakukan dalam mencegah dan mempercepat penyembuhan mukositis. Untuk itu, pendidikan kesehatan dan evaluasi secara rutin terkait perawatan mulut pada anak yang menderita leukemia menjadi penting untuk dilakukan.

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Leukemia is one of the types of cancer which most commonly found in urban communities, especially in children. The purpose of this scientific work is to describe nursing care to child who suffering leukemia and optimization of oral care in post-chemotherapy. Based on the assessment conducted on the management of diagnosed cases with acute lymphoblastic leukemia (ALL), obtained priority nursing problems that are inforced are ineffective airway clearance, oral mucous membrane damage, risk of injury, and risk of lack of fluid volume.

The evaluation results application of nursing showed that implementation of oral care such as teeth brushing and mouth rinsing with normal saline (0.9% NaCl). Regular oral care with normal saline is very effective in preventing and accelerating the healing process the mucositis. Therefore, health education and evaluation are routinely associated oral care in children with leukemia be important to do."

"Leukemia mieloblastik akut (LMA) merupakan kelainan sel punca hematopoetik yang dikarakterisasi oleh ekspansi progenitor mieloid yang tidak terdiferensiasi. Mutasi NPM1 ekson 12 merupakan perubahan genetik yang paling sering diketahui pada pasien LMA dengan kariotipe normal. Saat ini belum ada penelitian tentang mutasi ekson 12 gen NPM1 tipe A pada populasi Indonesia, sehingga belum ada data dan laporan mengenai mutasi ekson 12 gen NPM1 tipe A pada populasi orang Indonesia. Penelitian ini memiliki tujuan umum yaitu mengetahui karakteristik mutasi ekson 12 gen NPM1 pada pasien LMA dewasa di RSCM dan RSKD dan tujuan khusus yaitu mengetahui frekuensi kejadian mutasi tipe A pada ekson 12 gen NPM1 dan mengetahui benar atau tidaknya bahwa mutasi tersebut ditemukan pada pasien LMA dewasa di RSCM dan RSKD dengan kariotipe normal. Penelitian bersifat deskriptif dengan desain potong lintang. Sampel diperiksa dengan teknik ASO-RT-PCR dan hasil negatif dilanjutkan dengan seminested-ASO-RT-PCR. Hasil penelitian memperlihatkan 8 sampel (24,24%) dari total 33 sampel terdeteksi positif mengalami mutasi tipe A dan mutasi tersebut lebih banyak ditemukan pada pasien LMA dewasa di RSCM dan RSKD dengan kariotipe abnormal. Saran dari penelitian ini yaitu perlu dilakukan studi dengan jumlah sampel lebih banyak dan perlu dilakukan sequencing untuk mengetahui tipe mutasi lain dari ekson 12 gen NPM1.

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Acute Myeloid Leukemia (AML) is a hematopoietic stem cell disorders characterized by expansion of myeloid progenitors that are not differentiated. Exon 12 NPM1 mutations are the most frequent genetic alterations detected in AML patients with normal karyotype. Currently there is no study on type A exon 12 NPM1 gene mutation in Indonesian population. The general objective of this study was to determine the characteristic of exon 12 NPM1 gene mutation in adult AML patients at RSCM and RSKD. While the specific objectives were to determine the frequency of type A exon 12 NPM1 gene mutation and to observe if this mutation was found on adult AML patients with normal karyotype.

This research was designed as a cross sectional descriptive study. Samples were examined for type A mutation in exon 12 NPM1 gene using ASO-RT-PCR technique followed by seminested-ASO-RT-PCR for samples showing negative result. From this study, we found that 8 samples (24.24%) from a total of 33 samples were positively detected for type A mutation. In addition, we also found that this mutation was more frequent in adult AML patients with abnormal karyotype. Further study with larger number of samples and analysis by DNA sequencing is needed to better characterize this type A mutation and to find other type of mutation in exon 12 NPM1 gene respectively."

"Karya Ilmiah Akhir ini berisi laporan praktik selama program praktik residensi keperawatan medikal bedah 1 (satu) sampai 3 (tiga) di RSKD berupa analisis asuhan keperawatan pada pasien akut myeloid leukemia (AML) menggunakan teori peaceful end of life (EOL), menerapkan praktik keperawatan berdasarkan pembuktian serta melakukan inovasi keperawatan secara berkelompok. Pada pasien AML terdapat 10 diagnosa keperawatan yaitu nyeri akut, gangguan membran mukosa oral, resiko pertukaran gas, nutrisi kurang dari kebutuhan tubuh, intoleransi aktifitas, resiko infeksi, resiko perdarahan, tidak efektif manajemen kesehatan diri, spiritual distres, serta koping keluarga tidak efektif. Resume keperawatan pada 30 pasien dengan masalah keperawatan terbanyak adalah nyeri (70%), nausea (57%), fatigue (50%) dan cemas (40%). Penerapan praktik berbasis pembuktian adalah menerapkan penggunaan madu untuk mencegah terjadinya neutropenia pada pasien kanker. Inovasi keperawatan dilakukan secara berkelompok dengan membuat format pengkajian keperawatan lanjutan. Perawat dapat menerapkan teori peaceful EOL dalam asuhan keperawatan, menerapkan EBN penggunaan madu untuk mencegah neutropenia serta melakukan kegiatan inovatif dalam meningkatkan kualitas asuhan keperawatan pada pasien dengan keganasan

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This final Scientific report contains an analysis of practice during medical surgical nursing residency program 1 (one) to 3 (three) in RSKD to inform about nursing care withan acute myeloid leukemia (AML) patients using the theory of peaceful end of life (EOL), implementing evidence-based nursing practice and nursing innovation in groups. In AML patients there were 10 nursing diagnosis they are: acute pain, impaired oral mucous membranes, risk of gas exchange, nutrition less than body requirements, activity intolerance, risk of infection, risk of bleeding, ineffective self health management, spiritual distress, and ineffective family coping. Nursing resumes in 30 patients with the most nursing problems are: pain (70%), nausea (57%), fatigue (50%) and anxiety (40%). Application of evidence-based practice is to apply the use of honey to prevent neutropenia in cancer patients. Nursing innovation in groups by making advanced nursing assessment format. Nurses can apply theory peaceful EOL in nursing care setting, applying EBN use honey to prevent neutropenia and innovative activity in improving the quality of nursing care in patients with malignancy."

"Radikal bebas dapat dihasilkan dari proses inflamasi pada kasus penyakit gagal ginjal kronis. Ekstrak etanol daun binahong (Anredera cordifolia (Ten.) Steenis) diketahui memiliki kandungan flavonoid yakni kuersetin yang memiliki efek protektif dari pembentukan radikal bebas. Penelitian ini bertujuan untuk mengetahui dosis optimum ekstrak etanol daun binahong terhadap kerusakan ginjal kronik pada tikus galur Sparague Dawley. Penetapan hewan model menggunakan metode Unilateral Ureteral Obstruction (UUO) kecuali pada kelompok kontrol normal yang diberi perlakuan operasi sham. Tikus dibagi menjadi 7 kelompok yakni K1 (kontrol normal = sham + cairan pembawa), K2 (kontrol negatif = UUO + cairan pembawa), K3 (kontrol positif = UUO + losartan 1,18 mg/200 grBB), K4 (kontrol pembanding = UUO + kuersetin 9,9 mg/200grBB), D1 (dosis uji 1 = UUO + ekstrak etanol daun binahong 75 mg/kgBB), D2 (dosis uji 2 = UUO + ekstrak etanol daun binahong 150mg/kgBB), dan D3 (dosis uji 3 = UUO + ekstrak etanol daun binahong 300mg/kgBB). Masing-masing zat uji diberikan setelah satu hari perlakuan UUO selama 14 hari. Parameter yang akan diperiksa pada masing-masing kelompok yakni aktivitas enzim superoksida dismuthase (SOD), aktivitas enzim katalase, dan kadar malondialdehid (MDA). Hasilnya tidak terdapat perbedaan yang bermakna pada nilai kadar MDA dan aktivitas SOD antar kelompok perlakuan. Namun terdapat perbedaan yang bermakna pada nilai aktivitas katalase antar kelompok perlakuan. Dosis optimum belum dapat ditentukan karena nilai RSD pada hasil masing-masing kelompok lebih dari 15%.

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Free radicals can be produced from the inflammatory process in cases of chronic kidney failure. The ethanol extract of binahong leaves (Anredera cordifolia (Ten.) Steenis) is known to have a flavonoid content, quercetin which has a protective effect from the formation of free radicals. This study aims to determine the optimum dose of binahong leaf ethanol extract against chronic kidney damage in Sparague Dawley rats. Determination of animal models using the Unilateral Ureteral Obstruction (UUO) method except in the normal control group treated with sham operations. Rats were divided into 7 groups namely K1 (normal control = sham + carrier fluid), K2 (negative control = UUO + carrier fluid) K3 (positive control = UUO + losartan 1.18 mg / 200 grBW), K4 (comparative control = UUO + quercetin 9.9 mg / 200grBW), D1 (test dose 1 = UUO + ethanol extract binahong leaves 75 mg / kgBB), D2 (test dose 2 = UUO + extract Binahong ethanol leaves 150mg / kgBW), and D3 (test dose 3 = UUO + 300mg / kgBW leaves ethanol extract). Each test substance was given after one day of UUO treatment for 14 days. The parameters was examined in each group are the activity of the superoxide dismuthase (SOD) enzyme, catalase enzyme activity, and the level of malondialdehyde (MDA). The results showed there were no significant differences in the value of MDA levels and SOD activity between treatment groups. However, there were significant differences in the value of catalase activity between treatment groups. The optimum dose cannot be determined because the RSD value in this results of each group is more than > 15%."

"Karya Ilmiah Akhir ini berisi laporan praktik selama program praktik residensi keperawatan medikal bedah 1 (satu) sampai 3 (tiga) di RSKD berupa analisis asuhan keperawatan pada pasien akut myeloid leukemia (AML) menggunakan teori peaceful end of life (EOL), menerapkan praktik keperawatan berdasarkan pembuktian serta melakukan inovasi keperawatan secara berkelompok. Pada pasien AML terdapat 10 diagnosa keperawatan yaitu nyeri akut, gangguan membran mukosa oral, resiko pertukaran gas, nutrisi kurang dari kebutuhan tubuh, intoleransi aktifitas, resiko infeksi, resiko perdarahan, tidak efektif manajemen kesehatan diri, spiritual distres, serta koping keluarga tidak efektif. Resume keperawatan pada 30 pasien dengan masalah keperawatan terbanyak adalah nyeri (70%), nausea (57%), fatigue (50%) dan cemas (40%). Penerapan praktik berbasis pembuktian adalah menerapkan penggunaan madu untuk mencegah terjadinya neutropenia pada pasien kanker. lnovasi keperawatan dilakukan secara berkelompok dengan membuat format pengkajian keperawatan lanj utan. Perawat dapat menerapkan teori peaceful EOL dalam asuhan keperawatan, menerapkan EBN penggunaan madu untuk mencegah neutropenia serta melakukan kegiatan inovatif dalam meningkatkan kualitas asuhan keperawatan pada pasien dengan keganasan.

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This final Scientific report contains an analysis of practice during medical surgical nursing residency piogram 1 ( one) to 3 (three) in RSKD to inform about nursing care with an acute myeloid leukemia (AML) patients using the theory of peaceful end of life (EOL), implementing evidence-based nursing practice and nursing innovation in groups. In AML patients there were 10 nursing diagnosis they are: acute pain, impaired oral mucous membranes, risk of gas exchange, nutrition less than body requirements, activity intolerance, risk of infection, risk of bleeding, ineffective self health management, spiritual distress, and ineffective family coping.

Nursing resumes in 30 patients with the most nursing problems are: pain (70%), nausea (57%), fatigue (50%) and anxiety (40%). Application of evidence­based practice is to apply the use of honey to prevent neutropenia in cancer patients. Nursing innovation in groups by making advanced nursing assessment format. Nurses can apply theory peaceful EOL in nursing care setting, applying EBN use honey to prevent neutropenia and innovative activity in improving the quality of nursing care in patients with malignancy. "

"Karya ilmiah akhir ini merupakan praktik klinik lanjut keperawatan medikal bedah pada kasus keganasan yang terdiri dari pengelolaan kasus utama Leukimia Myeloid Akut dan 30 resume menggunakan pendekatan Model Konservasi Levine, penerapan Evidence Based Nursing EBN penggunaan larutan lidah buaya pada pasien leukemia dan limfoma yang menderita stomatitis akibat kemoterapi serta inovasi keperawatan modifikasi pengkajian Malignant Wound Assessment Tool MWAT . Masalah keperawatan terbanyak yang muncul pada konservasi energi adalah nyeri, konservasi integritas struktural adalah resiko tinggi infeksi, konservasi integritas personal adalah cemas dan konservasi integritas sosial adalah hambatan interaksi sosial. Penggunaan larutan lidah buaya mampu menurunkan stomatitis dan nyeri stomatitis pada pasien leukemia yang mendapatkan kemoterapi. Modifikasi pengkajian MWAT dan asuhan keperawatan pada pasien luka kanker diharapkan mampu meningkatkan asuhan keperawatan yang berkualitas.

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This Scientific report was an advanced medical surgical nursing clinical practice of malignancies cases consist one major case of Acute Myeloid Leukemia and 30 summaries using Levine rsquo s Conservation Model, the application of Evidence Based Nursing EBN applying aloe vera solution in patients with leukemia and lymphoma chemotherapy induced mucositis and nursing innovation Malignant Wound Assessment Tool MWAT assessment modification. The majority of nursing problems that arise on energy conservation was pain, in structural integrity conservation was high risk of infection, in personal integrity conservation was anxiety and social integrity conservation was a social interaction impaired. Aloe vera solution was able to reduce mucositis and pain in patients with leukemia that received chemotherapy. MWAT assessment modifications and nursing care in patients with wound cancer might increase the quality of nursing care."

"Sitronelol dan geraniol dilaporkan mempunyai aktivitas antibakteri,antiinflamasi dan sitotoksik terhadap beberapa sel kanker. Hasil uji sitotoksiksitronelol dan geraniol terhadap sel kanker murine leukimia P388 menunjukkanbahwa, sitronelol dan geraniol mempunyai aktivitas sitotoksik terhadap sel kankertersebut. Untuk meningkatkan aktivitas sitotoksik, kedua senyawa tersebut dirancangmenjadi sejumlah senyawa ester dan diskrining virtual terhadap reseptor proteinproviral insertion site in Moloney murine leukemia virus-1 Pim1 kinase denganperangkat lunak Molegro Virtual Docker MVD . Hasil skrining virtual menunjukkanbahwa senyawa ester hasil rancangan mempunyai potensi sebagai antikanker dandisintesis 8 senyawa ester terpilih yaitu sitronelil kaproat, geranil kaproat, sitronelilisobutirat, geranil isobutirat, sitronelil 2,2-dimetil butirat, geranil 2,2-dimetil butirat,sitronelil kaprilat dan geranil kaprilat. Senyawa ester hasil sintesis dianalisis awalmenggunakan KLT, dimurnikan menggunakan kolom kromatografi, dielusidasistrukturnya menggunakan FTIR dan NMR serta dianalisis spektro massanyamenggunakan GCMS. Analisis toksisitas senyawa ester hasil sintesis dengan metodeBSLT menunjukkan bahwa, ester sitronelol dan geraniol hasil sintesis toksik terhadaplarva udang Artemia salina dengan nilai LC50 1,21-1,96 ?g/mL, sehingga berpotensisebagai senyawa antikanker. Hasil uji aktivitas sitotoksik terhadap sel murineleukimia P388 secara in vitro dengan metode MTT menunjukkan bahwa, estersitronelol dan geraniol hasil sintesis sitotoksik terhadap P388 dengan nilai IC50 10,63-37,69 ?g/mL. Aktivitas sitotoksik ester sitronelil kaproat yang disintesis dari asamkaproat minyak inti sawit sekitar 4 kali lebih kuat daripada sitronelol. Senyawa yangaktivitas sitotoksiknya lebih tinggi daripada senyawa induk, selanjutnya diujisitotoksik terhadap sel kanker payudara MCF7 dengan metode alamar blue. Hasil ujisitotoksik ini menunjukkan bahwa senyawa ester sitronelil isobutirat, sitronelil 2,2-dimetil butirat, geranil isobutirat dan geranil 2,2-dimetil butirat sitotoksik terhadapMCF7 dengan nilai IC50 1,32-4,83 ?g/mL. Hidrofobisitas log P senyawaberpengaruh terhadap aktivitas sitotoksik.

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Citronellol and geraniol have been reported as an antibacterial, anti inflammatory andcytotoxic against some cancer cells. The cytotoxic test result both of citronellol andgeraniol against murine leukemia P388 cancer cells showed that citronellol andgeraniol have cytotoxic activity against the cancer cells. To enhance the cytotoxicactivity both of the compounds, the compounds were designed into a number of estercompounds and virtual screened against the target receptor of proviral insertion sitein Moloney murine leukemia virus 1 Pim1 kinase using Molegro Virtual Docker MVD software. The virtual screening result showed that citronellol and geraniolesters have potential as anticancer and 8 ester compounds selected that are citronellylcaproate, geranyl caproate, citronellyl isobutyrate, geranyl isobutyrate, citronellyl2,2 dimethyl butyrate, geranyl 2,2 dimethyl butyrate, citronellyl caprylate and geranilcaprylate further synthesized. The synthesized ester compounds were preliminaryanalyzed by TLC, purified by column chromatography, elucidated the molecularstructure using FTIR and NMR and analyzed the mass spectra using GCMS. Toxicityanalysis of ester compounds by BSLT method showed that, citronellol and geraniolesters toxic against Artemia salina Leach shrimp larvae with LC50 values of 1.21 1.96mg mL, thereby potentially as anticancer compound. The result of in vitro cytotoxicactivity of esters against murine leukemia P388 cancer cells by MTT method showedthat, citronellol and geraniol esters cytotoxic against P388 cancer cells with IC50values of 10.63 37.69 g mL. The cytotoxic activity of citronellyl caproate thatsynthesized from caproic acid of palm kernel oil was about 4 more active thancitronellol. Ester compounds that have higher cytotoxic activity than startingcompound, then were tested for cytotoxic activity against breast MCF7 cancer cellsby alamar blue method, The result showed that citronellyl isobutyrate, citronellyl 2,2 dimethyl butyrate, geranyl isobutyrate and geranyl 2,2 dimethyl butyrate activeagainst MCF7 cancer cells with IC50 values of 1.32 4.83 g mL. Hydrophobicity logP of ester compounds effect on the cytotoxic activity."

"From the world renowned Fred Hutchinson Cancer Research Center, this book is written for all physicians who treat patients with acute or chronic leukemias or myelodysplasia. It is designed to answer questions about treatment approaches that commonly arise in day-to-day practice. In keeping with the center’s groundbreaking research in bone marrow transplantation, the book provides exceptional coverage of the role of allogeneic transplant in treatment. It also addresses the important issues of supportive care and long-term complications of successful treatment. •Edited and written by experts at the Fred Hutchinson Cancer Research Center•Clinically focused and comprehensive coverage of treatment approaches• Allogeneic transplant addressed in detail• Separate chapters on supportive care and long-term complications"