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"Latar belakang: Penyakit tiroiditis autoimun pada anak dapat bermanifestasi sebagai hipotiroid, hipotiroid subklinis, eutiroid atau hipertiroid. Belum ada kesepakatan pemberian terapi levotiroksin pada keadaan eutiroid, meskipun beberapa penelitian menyatakan manfaat untuk mengurangi volume tiroid, mempengaruhi fungsi tiroid serta menstabilkan proses imunologis yang berlangsung.Tujuan: Mengetahui efek pemberian levotiroksin terhadap perubahan volume tiroid, fungsi tiroid dan antibodi tiroid pada anak eutiroid dengan tiroiditis autoimun.Metode: review sistematik (metaanalisis) penelitian-penelitian pada anak eutiroid dengan tiroiditis autoimun yang diberikan levotiroksin terhadap perubahan volume tiroid. Penelusuran dilakukan dari the Cochrane Library, MEDLINE, EBSCO, Proquest, clinicaltrials.gov serta sumber-sumber lain. Kriteria inklusi adalah studi pada populasi tersebut dengan desain randomised control trials dan quasi-randomised trials dengan luaran primer volume tiroid. Dua peneliti secara independen melakukan ekstraksi data, menilai risiko bias tiap studi yang diinklusi, melakukan pooled data menggunakan random effect model dan melakukan analisis sensitivitas.Hasil: Sebanyak 48 penelitian/studi teridentifikasi dengan metode penelusuran yang disusun, setelah dianalisis didapatkan 2 (dua) penelitian (80 subyek) yang memenuhi kriteria inklusi. Hanya data volume tiroid SDS yang dapat diagregrasi dari kedua penelitian. Perbedaan perubahan volume tiroid sebesar -1,18 (IK95%; -1,65; -0,70) SDS pada pemberian levotiroksin dibandingkan kontrol. Perbedaan perubahan rerata kadar TSH, fT4, TPOAb dan TgAb antara kelompok intervensi dibandingkan kelompok kontrol adalah -0,24 mU/liter (IK95% -1,96; 1,12); -0,76 pmol/liter (IK95% -4,77; 3,25); 135,2 U/ml (IK95% -319,8; 590,2); dan -75,53 U/mililiter (IK95% -255,32; 104,26). Pemberian levotiroksin memberikan efek kejadian goiter yang lebih sedikit (3 subyek) dibandingkan dengan kontrol (17 subyek) (rasio odd 0,06; IK95% 0,01-0,28).Kesimpulan: Terapi levotiroksin pada anak tiroiditis autoimun yang eutiroid mungkin bermanfaat dalam menurunkan volume tiroid (SDS) dan risiko kejadian goiter. Terapi levotiroksin pada anak tiroiditis autoimun yang eutiroid belum terbukti mempengaruhi perubahan kadar TSH, fT4, TPOAb dan TgAb.

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Background: Children with autoimmune thyroiditis may manifest as overt hypothyroidism, subclinical hypothyroidism, euthyroid or hyperthyroidism. Although there is no consensus on treating euthyroid condition in thyroiditis autoimmune children, some studies showed efficacy of levothyroxine in decreasing thyroid volume, improving thyroid function, and stabilizing immunological process.Objectives: to determine the effect of levothyroxine on thyroid volume changes, thyroid functions and thyroid antibodies in euthyroid children with autoimmune thyroiditis.Methods: Systematic review was performed in euthyroid children with autoimmune thyroiditis. Electronic databases search (the Cochrane Library, MEDLINE, EBSCO, Proquest, clinicaltrials.gov and other sources) and non-electronic search (handsearch of journals, conference proceeding) were done. Randomised and quasi-randomised controlled trials comparing levothyroxine to control in all euthyroid children with autoimmune thyroiditis were selected. Two person independently extracted data, assessed the risk of bias, analyzed pooled data from included study by random effect model and performed sensitivity analysis.Results: Two studies (80 participants) were included from 48 studies identified from searching methods. Only thyroid volume SDS data could be aggregated. Mean difference of thyroid volume change was -1,18 (95%CI; -1,65; -0,70) SDS between levothyroxine and control. Mean difference of TSH, fT4, TPOAb and TgAb change between levothyroxine and control were -0,24 mU/liter (IK95% -1,96; 1,12); -0,76 pmol/liter (95%CI -4,77; 3,25); 135,2 U/ml (95%CI -319,8; 590,2); and -75,53 U/mililiter (95%CI -255,32; 104,26). Risk of goiter was decreasing with levothyroxine treatment (OR 0,06; IK95% 0,01-0,28).Conclusion: Levothyroxine treatment for euthyroid children with autoimmune thyroid might reduce thyroid volume (SDS) and risk of goiter. Treatment of levothyroxine do not conclusively improve changes of TSH, fT4, TPOAb and TgAb."

"[Latar belakang. Hiperplasia Adrenal Kongenital (HAK) merupakan kelainanautosomal resesif yang mengganggu pembentukan sintesis kortisol sehinggamembutuhkan terapi glukokortikoid seumur hidup. Terdapat kontroversi efekpemberian glukokortikoid pada anak HAK terhadap BMD.Tujuan. Mengetahui efek pemberian glukokortikoid terhadap BMD pada anakdengan HAK Metode. Systematic review dan meta-analisis dari literatur yang ada sepertiCohrane library, MEDLINE, EBSCO, PROQUEST, dan database teregistrasilainnya dilakukan untuk mencari penelitian yang terkait BMD pada HAK. Duapeneliti secara independen melakukan review terhadap abstrak sesuai kriteriainklusi dan naskah lengkap untuk ekstraksi data. Hasil. Terdapat 9 penelitian yang sesuai kriteria systematic review dan 4penelitian masuk ke dalam meta-analisis. Hasil meta-analisis menunjukkan tidakterdapat perbedaan mean difference Whole BMD Z-Score dan Lumbar spine BMDZ-Score antara anak HAK yang mendapatkan terapi glukokortikoid dibandingkandengan kontrol anak normal (berturut-turut p=0.57, 95% CI, -0.46-0.84 dan p =0,86 ;CI 95%, -2,3 – 1,94)Kesimpulan. Whole BMD dan Lumbar spine BMD Z-Score pada anak HAK yang mendapatkan glukokortikoid tidak berbeda dengan anak normal. , Background : Congenital Adrenal Hyperplasia (CAH) is an autosomalrecessive disorders characterized by impared cortisol synthesis which is needglucocorticoid for long life treatment. There was conflicting results regardingeffect of glucocorticoid treatment on bone mineral density (BMD) in CAHpatients. Objective. To determine the effect of glucocorticoid treatment on BMD inchildren with CAH. Method. We performed systematic review and meta-analysis of existing literatureusing Cohrane library, MEDLINE, EBSCO, PROQUEST, and other database toidentify studies of BMD and CAH. Two authors reviewed independently abtractsfor inclusion and read full- text artices to extract data. Result. There was 9 studies met eligibility criteria for systematic review and 4studies included in to meta-analysis. Meta-analysis showed there was nosignificant mean difference Whole BMD Z-Score and Lumbar spine BMD ZScorebetween children with CAH who treated with glucocorticoid compared tonormal healthy child (p=0.57, 95% CI, -0.46-0.84 and p = 0,86 ;CI 95%, -2,3 –1,94, respectively)Conclusion. Whole BMD and Lumbar spine BMD Z-Score in children with CAH treated with glucocorticoid is similar with normal children. ]"

"[ABSTRAKTujuan : Untuk menentukan apakah PICC dan PIVC pada bayi berat lahir sangat rendah berbeda, yang merujuk pada: kejadian sepsis, Jumlah pemakaian kateter yang dibutuhkan untuk keseluruhan terapi intravena dan efisiensi biaya pemasangan akses vena. Metoda: desain potong lintang retrospektif terhadap rekam medis semua bayi dengan berat lahir sangat rendah yang mendapatkan akses vena di divisi neonatologi RSCM periode tahun 2012 - 2014. Hasil: terdapat 161 kelompok PICC dan 154 kelompok PIVC. Karakteristik kedua kelompok tidak didapatkan perbedaan yang signifikan (p > 0,05). Terdapat perbedaan yang signifikan antara 2 kelompok untuk jumlah pemakaian (p=0,000). Biaya yang dibutuhkan untuk pemasangan kateter berbeda bermakna pada kedua kelompok (p<0,28). Kejadian infeksi aliran darah lebih tinggi pada kelompok PIVC. Beberapa bayi memiliki lebih dari satu episode sepsis, terdapat perbedaan yang signifikan (p = .032). Simpulan: PICC lebih efektif dan efisien dibandingkan PIVC.

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ABSTRACTBackground: To determine whether the PICC and PIVC in low birth weight infants differ on: the incidence of sepsis, the amount of catheter needed for the overall intravenous therapy, IV and the efficiency of cost on installation venous access. Methods: A cross-sectional retrospective design of the medical records of all infants with very low birth weight who gain venous access in neonatology division RSCM period 2012 to 2014. The comparison of proportions between groups were analyzed with SPSS of which P value <0.05 was considered statistically significant. Results: Characteristics of the two groups was not found significantly differences (p> 0.05). There are significant differences between the 2 groups for the number and the duration of the use (p = 0.000), the cost required for catheter (p <0.28) and the incidence of bloodstream infections was higher in the group PIVC. Some babies have more than one episode of sepsis, which are significantly different (p = .032). Conclusion: PICC is more effective and efficient then PIVC. , Background: To determine whether the PICC and PIVC in low birth weight infants differ on: the incidence of sepsis, the amount of catheter needed for the overall intravenous therapy, IV and the efficiency of cost on installation venous access. Methods: A cross-sectional retrospective design of the medical records of all infants with very low birth weight who gain venous access in neonatology division RSCM period 2012 to 2014. The comparison of proportions between groups were analyzed with SPSS of which P value <0.05 was considered statistically significant. Results: Characteristics of the two groups was not found significantly differences (p> 0.05). There are significant differences between the 2 groups for the number and the duration of the use (p = 0.000), the cost required for catheter (p <0.28) and the incidence of bloodstream infections was higher in the group PIVC. Some babies have more than one episode of sepsis, which are significantly different (p = .032). Conclusion: PICC is more effective and efficient then PIVC. ]"

"ABSTRAKLatar Belakang. Biomarker dapat digunakan untuk memprediksi derajat keparahan trauma kepala.Tujuan. Mengetahui hubungan antara kadar S100B dengan derajat keparahan trauma kepala dan kelainan CT scan kepala.Metode Penelitian. Penelitian potong lintang di IGD RSUPN Cipto Mangunkusumo, RSUP Fatmawati, dan RS Permata Cibubur selama Juli-Desember 2015. Subjek adalah anak usia 1-18 tahun yang mengalami trauma kepala dengan onset <24 jam. Setiap subjek dilakukan pemeriksaan skor Skala Koma Glasgow Pediatrik, pemeriksaan CT scan kepala bila terdapat indikasi, serta pemeriksaan kadar S100B dari serum.Hasil Penelitian. Subjek penelitian terdiri atas 20 subjek trauma kepala ringan dan 18 subjek trauma kepala sedang. Hasil penelitian menunjukkan terdapat perbedaan bermakna kadar S100B kelompok trauma trauma kepala sedang dan kepala ringan; median (rentang) 0,173 (0,054-0,812) μg/L dibandingkan 0,067 (0,039-0,084) μg/L, p<0,001. Selain itu juga terdapat perbedaan bermakna antara kelompok yang terdapat kelainan CT scan kepala dibandingkan dengan yang tidak ada kelainan; 0,124 (0,051-0,812) μg/L dan 0,067 (0,039-0,084) μg/L, p=0,001. Berdasarkan analisis ROC, kadar S100B serum sangat kuat untuk memprediksi trauma kepala sedang (AUC 0,818, p=0,001 dan IK95% 0,668-0,969) dengan nilai cut-off 0,083 μg/L.Simpulan. Kadar S100B serum pada trauma kepala sedang secara bermakna lebih tinggi dari trauma kepala ringan serta memiliki kemampuan diskriminasi sangat baik untuk memprediksi derajat keparahannya.

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ABSTRACT

Background. Biomarker has ability to predict the severity of TBI and abnormal CT scan.

Objectives. To determine the association between S100B level with the severity of pediatric TBI and intracranial injury.

Methods. A cross-sectional study at Emergency Department of RSUPN Cipto Mangunkusumo, RSUP Fatmawati, and Permata Cibubur Hospital on July- December 2015. Subjects were 1-18 year-old children with TBI, onset within 24 hours before admission. We measured Pediatric GCS score, serum S100B level, and performed cranial CT scan if indicated.

Results. Twenty subjects had mild TBI and 18 subjects had moderate TBI were included. S100B levels were higher in children with moderate TBI as compared to children with mild TBI; 0,173 (0,054-0,812) μg/L vs 0,067 (0,039-0,084) μg/L, p<0,001. S100B levels were significantly elevated in children following TBI with abnormal cranial CT scan as compared to children with a normal CT scan (0,124 (0,051-0,812) μg/L vs 0,067 (0,039-0,084) μg/L, p=0,001). AUC for S100B was also significant (0,818, p=0,001, CI95% 0,668-0,969) as prediction of moderate TBI with cut-off point 0,083 μg/L.

Conclusions. Children with moderate TBI had significantly higher S100B levels as compared to children with mild TBI. Cut-off point S100B level at 0,083 μg/L has good ability to predict the severity of TBI."