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"ABSTRAK Latar Belakang: Mayoritas anak dengan HIV memiliki masalah fungsi susunan saraf pusat SSP dan neurokognitif walaupun telah mendapatkan ARV. Gangguan fungsi SSP dan neurokognitif perlu dimonitor secara jangka panjang. Tujuan: Mengetahui perubahan IQ dan gambaran EEG pada pasien HIV anak yang telah memperoleh ARV. Metode: Penelitian kohort retrospektif pada 63 anak dengan HIV berusia 7-17 tahun yang telah memperoleh ARV pasca follow-up dalam 3 tahun dilakukan di Rumah Sakit Cipto Mangunkusumo RSCM . Dilakukan anamnesis, tes IQ, dan EEG. Selanjutnya, dinilai perubahan proporsi IQ dan EEG serta hubungan perubahan IQ dengan stadium klinis HIV, penyakit infeksi SSP, jenis ARV, keteraturan minum ARV, dan jenis sekolah. Hasil: Perubahan proporsi IQ normal menjadi abnormal pada verbal scale, performance, dan full-scale adalah 13 20,6 subyek p=0,002 , 12 19 subyek p=0,035 , dan 10 15,9 subyek p=0,039 . Perubahan proporsi verbal, performance, dan full-scale IQ tidak berhubungan dengan stadium HIV, infeksi SSP, keteraturan minum ARV, dan tipe sekolah. Perubahan proporsi EEG normal menjadi abnormal sebanyak 19 subyek 30,2 p=0,003 . Simpulan: Obat anti retroviral jangka panjang tidak memperbaiki IQ dan gambaran EEG pada pasien HIV anak.

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ABSTRACT

Background: A majority of HIV-infected children are dealing with central nervous system CNS dysfunction and neurocognitive disorder. CNS dysfunction and neurocognitive disorder need to be monitored in the long-term. Objective: To identify altered IQ and EEG activity in HIV-infected children who had received ARV treatment. Methods: A retrospective cohort study in HIV-infected children aged 7 to 17 years who had received ARV and had 3-year follow up was conducted in Cipto Mangunkusumo Hospital CMH . History taking, IQ test, and EEG was performed. We evaluated changes in IQ proportion, EEG activity and the correlation between altered IQ and HIV infection stages, CNS infection, ARV type, medication adherence and school type. Results: There was an altered proportion of IQ score from normal into abnormal for verbal scale, performance and full scale scores, which occurred in 13 20.6 subjects p=0.002 , 12 19 subjects p=0.035 , and 10 15.9 subjects p=0.039 , respectively; The altered IQ proportion had no correlation with HIV infection stages, CNS infection, medication adherence and school type. The altered proportion of EEG activity was found in 19 30.2 subjects p=0.003 . Conclusion: Long-term ARV does not improve the IQ score and EEG activity in HIV-infected children."

"Latar Belakang : Asfiksia neonatorum menyebabkan gangguan multiorgan, salah satunya adalah gangguan ginjal. Belum adanya kesepakatan dalam menentukan gangguan ginjal akut (acute kidney injury, AKI) pada neonatus menyebabkan kesulitan dalam mendiagnosis dan selanjutnya menghambat tata laksana AKI. Acute Kidney Injury Network (AKIN) merekomendasikan kriteria AKI berdasarkan peningkatan kadar kreatinin serum dan penurunan luaran urin.Tujuan : Mengetahui prevalens AKI dengan menggunakan kriteria AKIN pada asfiksia neonatorum, dan mengetahui perbedaan stadium AKI antara asfiksia sedang dan berat.Metode : Studi ini merupakan potong lintang analitik yang berlangsung selama Juli 2012 hingga Januari 2013. Subjek penelitian adalah semua bayi baru lahir usia gestasi >35 minggu dengan asfiksia yang lahir dan dirawat di Divisi Neonatologi RS Cipto Mangunkusumo dan RSUD Koja. Analisis menggunakan uji hipotesis Chi-square dengan SPSS versi 20.Hasil : Penelitian dilakukan pada 94 subjek yang terdiri atas 70 neonatus asfiksia sedang dan 24 neonatus asfiksia berat. Prevalens AKI berdasarkan kriteria AKIN pada asfiksia neonatorum adalah 63%. Prevalens bayi dengan asfiksia berat dan sedang yang mengalami AKI berturut-turut adalah 21 dari 24 subjek (88%) dan 38 subjek (54%). Prevalens bayi dengan asfiksia berat mengalami AKI stadium 3 yang terbanyak yaitu 14 dari 21 subjek (67%). Stadium AKI yang lebih berat lebih banyak dijumpai pada bayi dengan asfiksia berat dibandingkan asfiksia sedang (P<0,001).Simpulan : Prevalens AKI pada asfiksia neonatorum cukup tinggi. Makin berat derajat asfiksia neonatorum, makin berat stadium AKI.

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Background: Asphyxia neonatorum may result in multiorgan disfunction including renal disfunction. There is no consensus on the determination of acute kidney injury (AKI) in neonates making establishment of the diagnosis and its management difficult. The Acute Kidney Injury Network (AKIN) recommends AKI criteria based on increased serum creatinine level and reduced urine output.

Objective: To identify the prevalence of AKI in asphyxiated neonates using the AKIN criteria and to recognize the difference of AKI stadium between moderate and severe asphyxia.

Methods: The study was a cross-sectional analytical study, which was conducted between July 2012 and January 2013. The study subjects were all asphyxiated neonates with gestational age of >35 weeks who were delivered and hospitalized in Cipto Mangunkusumo Hospital and Koja District Hospital. Analysis was performed by hypothesis Chi-square test using SPSS version 20.

Results: Of 94 subjects participated in the study, there were 70 and 24 neonates with moderate and severe asphyxia, respectively. The prevalence of AKI was 63%. The prevalence of neonates with severe and moderate asphyxia who experienced AKI was 21 out of 24 subjects (88%) and 38 subjects (54%), respectively. The prevalence of AKI in neonates with severe asphyxia who had stage 3 AKI was 14 out of 21 subjects (67%). More severe AKI stage was found more common in neonates with severe asphyxia (P<0.001)

Conclusions: The prevalence of AKI in neonatal asphyxia is high. The more severe stage of neonatal asphyxia, the more severe the AKI stage"