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All Journal Medical Journal of Indonesia Sari Pediatri Paediatrica Indonesiana
Novie Amelia Chozie
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia /Rumah Sakit Cipto Mangunkusumo, Jakarta
Health Professions Medicine & Pharmacology

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Efektivitas Premedikasi untuk Pencegahan Reaksi Transfusi Nadia Devina Esmeralda; Novie Amelia Chozie
Sari Pediatri Vol 17, No 4 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (134.383 KB) | DOI: 10.14238/sp17.4.2015.312-6

Abstract

Latar belakang. Penggunaan premedikasi sebelum transfusi meskipun masih digunakan secara luas namun menjadi kontroversi sampai saat ini karena efektivitasnya belum diketahui dengan pasti.Tujuan. Mengetahui efektivitas pemberian premedikasi untuk mencegah reaksi transfusi.Metode. Penelusuran pustaka secara online dengan mempergunakan instrumen pencari Pubmed, Cochrane Library, dan Google. Kata kunci yang digunakan adalah ”premedication”,”transfusion” dan “transfusion reaction”.Hasil. Terdapat 3 artikel yang dianggap relevan dengan masalah. Penelitian retrospekstif penggunaan premedikasi pada pasien yang diberikan transfusi dengan asetaminofen dan difenhidramin tidak terdapat perbedaan dalam kejadian reaksi transfusi antara kelompok yang diberikan premedikasi dengan plasebo. Penelitian prospektif selama 3 tahun menyimpulkan bahwa pemberian premedikasi dapat dikurangi tanpa meningkatkan reaksi transfusi. Cochrane Collaboration melakukan telaah sistematik mengenai premedikasi mendapatkan hasil, reaksi alergi pada kelompok premedikasi RR 1,45 (0,78-2,72) dan untuk reaksi demam didapatkan hasil pada kelompok premedikasi RR 0,52 (0,21-1,25).Kesimpulan. Pemberian premedikasi sebelum transfusi tidak terbukti efektif dalam mencegah reaksi transfusi.
Variabilitas Pola Perdarahan Anak Hemofilia A yang Mendapat Terapi On-demand di Rumah Sakit Cipto Mangunkusumo Novie Amelia Chozie; Yuniasti Evitasari; Darmawan Budi Setyanto
Sari Pediatri Vol 20, No 4 (2018)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.332 KB) | DOI: 10.14238/sp20.4.2018.221-9

Abstract

Latar belakang. Gejala perdarahan pada hemofilia A bergantung pada kadar faktor VIII, namun pada kadar faktor koagulasi yang sama dapat terjadi perbedaan karakteristik dan luaran klinis. Tujuan. Mengidentifikasi pola perdarahan, terapi dan komplikasi pada anak hemofilia A. Metode. Penelitian kohort retrospektif pada anak ≤18 tahun di RSCM. Data diambil dari rekam medis (Januari 2014 – Juni 2016) meliputi data usia awitan perdarahan sendi, usia saat diagnosis, kekerapan perdarahan, lokasi perdarahan, penggunaan faktor VIII, dan komplikasi yang dialami. Hasil. Terdapat 109 anak lelaki terdiri dari 2,8% hemofilia A ringan, 27,5% hemofilia A sedang, dan 69,7% hemofilia A berat. Perdarahan tersering ditemukan pada sendi (60,6%) terutama pada lutut (37,2%). Dibandingkan hemofilia A ringan dan sedang, anak hemofilia A berat menunjukkan usia awitan perdarahan sendi lebih dini (median 12,5 (4-120) bulan), kekerapan perdarahan sendi lebih sering (median 8 (1-44) kali/tahun), dan menggunakan konsentrat faktor VIII lebih banyak (median 712 (131-1913) IU/kg/tahun). Komplikasi terbanyak adalah artropati dan sinovitis kronik (46,8%) serta inhibitor faktor VIII (7,3%). Terdapat 9 dari 71 (12,6)% subjek hemofilia A berat menunjukkan karakteristik klinis lebih ringan. Kesimpulan. Pola perdarahan pada anak hemofilia A sesuai kadar faktor VIII, tetapi pada hemofilia A berat terdapat variabilitas subjek dengan gejala klinis lebih ringan.
Terapi Antikoagulan pada Anak Novie Amelia Chozie; Raisa Cecilia Sarita
Sari Pediatri Vol 23, No 3 (2021)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp23.3.2021.205-14

Abstract

Seiring berkembangnya pengobatan dan teknologi di rumah sakit seperti pemasangan akses vaskular, serta kondisi penyakit pada anak, maka faktor risiko kejadian trombosis pada anak juga semakin meningkat. Kejadian trombosis ini perlu penanganan berupa terapi antikoagulan yang bertujuan untuk menurunkan risiko emboli, mencegah komplikasi, dan profilaksis bagi individu yang berisiko. Penggunaan antikoagulan pada anak di praktik klinis sehari-hari sebagian besar menggunakan data ekstrapolasi dari hasil studi pada orang dewasa. Terbatasnya data yang ada saat ini dan sistem hemostasis anak yang berbeda dengan dewasa menyebabkan penggunaan antikoagulan pada anak menjadi tantangan khusus. Beberapa pilihan terapi antikoagulan masing-masing memiliki kelebihan dan kekurangannya baik dari sisi pengaturan dosis, frekuensi pemberian, pemantauan, efikasi dan efek samping. Tinjauan pustaka ini akan membahas penggunaan antikoagulan pada anak khususnya heparin (unfractionated heparin, low molecular weight heparin), warfarin, dan perkembangan studi antikoagulan oral baru, serta pada populasi khusus yaitu anak dengan keganasan, sindrom lupus eritematosus, dan infeksi virus SARS-COV-2. 
Efektivitas Transfusi Trombosit Hasil Uji Silang Serasi (Crossmatch) pada Kondisi Trombositopenia Refrakter Murti Andriastuti; Novie Amelia Chozie; Syahminar Rahmani
Sari Pediatri Vol 20, No 1 (2018)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp20.1.2018.50-7

Abstract

Latar belakang. Penyebab imun tersering trombositopenia refrakter adalah adanya antibodi terhadap human leukocyte antigens (HLA) dan atau human platelet antigens (HPA). Salah satu strategi untuk mengidentifikasi unit trombosit yang kompatibel untuk resipien adalah dengan uji silang serasi (crossmatching).Tujuan. Mengetahui efektivitas uji silang serasi sebagai tata laksana trombositopenia refrakter.Metode. Penelusuran literatur secara daring, digunakan instrumen pencari Pubmed, Cochrane, Clinical key, dan Google Scholar. Kata kunci yang digunakan adalah ”crossmatching”,”platelet transfusion”,“thrombocytopenia”, “refractory”, dan “efficacy”.Hasil. Terdapat 3 artikel yang relevan dengan masalah. Penelitian kohort terhadap 100 transfusi trombosit dengan uji silang serasi menunjukkan hasil rerata 24 jam jumlah trombosit pascatransfusi secara signifikan lebih tinggi pada kelompok kompatibel (9,250±026,6) daripada kelompok inkompatibel (6,757.94±2,656.5), p<0.0001. Penelitian kohort yang kedua juga menunjukkan perbedaan kenaikan jumlah trombosit pascatransfusi antara kelompok kompatibel dan inkompatibel bermakna secara signifikan (p=0,041). Pada penelitian kohort ketiga, transfusi trombosit inkompatibel terbukti meningkatkan risiko terjadinya respons kenaikan trombosit yang buruk pada 1 jam (OR: 5,38; 95% CI: 2,060-14,073; p<0,001), tetapi tidak pada 24 jam (OR: 1,400; CI: 0,572-3,434; p=0,46). Terdapat perbedaan bermakna antara jumlah absolut trombosit pada 1 jam dan 24 jam pascatransfusi trombosit (p<0,001). Kesimpulan. Transfusi trombosit hasil uji silang serasi yang kompatibel efektif diberikan pada pasien dengan kondisi trombositopenia refrakter.
Pemantauan Kerusakan Sendi pada Anak Hemofilia Berat: Peran Pemeriksaan Muskuloskeletal (HJHS), Ultrasonografi Sendi dan Kadar C-Terminal Telopeptide of Type II Collagen Urin Teny Tjitra Sari; Novie Amelia Chozie; Djajadiman Gatot
Sari Pediatri Vol 17, No 3 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.725 KB) | DOI: 10.14238/sp17.3.2015.234-40

Abstract

Hemartrosis dan artropati hemofilik merupakan morbiditas utama hemofilia. Patogenesis artropati hemofilik masih belum diketahuidengan jelas, diduga meliputi proses degenerasi dan inflamasi. Deteksi dini tahap awal artropati hemofilik sebelum timbul gejalaklinis sangat diperlukan untuk mencegah progresivitas kerusakan sendi. Pemeriksaan muskuloskeletal dengan metode skoringHemophilia Joint Health Score (HJHS) sensitif untuk mendeteksi artropati hemofilik tahap dini. Ultrasonografi sendi memilikisensitivitas yang baik dalam mendeteksi artropati tahap dini, berbiaya lebih murah dan lebih praktis dibanding MRI. Peran petandabiologis kerusakan sendi seperti kadar C-terminal Telopeptide of Type II Collagen (CTX-II) urin sebagai penunjang diagnostikartropati tahap dini dan evaluasi keberhasilan terapi masih memerlukan penelitian lebih lanjut sebelum dapat digunakan dalampraktek sehari-hari. Tinjauan pustaka ini membahas patofisiologi dan pemantauan artropati hemofilik secara klinis, radiologisdan pemeriksaan petanda biologis kerusakan sendi.
Activation of coagulation system and d-dimer levels in children with acute leukemia Harun Wijaya; Novie Amelia Chozie; Badriul Hegar
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.6 KB) | DOI: 10.14238/pi54.4.2014.227-31

Abstract

Background D-dimer is a molecule as result of breaking downof excessive fibrin formation from the activation of coagulationsystem. There is evidence of increased activation of coagulation inpatients with acute leukemia which was showed by the incrementof d-dimer levels.Objective To evaluate the incidence of activation of coagulationsys tem in children with acute leukemia before receivingchemotherapy.Method This cross-sectional study was performed at Dr. CiptoMangunkusumo Hospital. All newly-diagnosed children with acuteleukemia were included in this study, prior to their receiving anychemotherapy treatment. Blast count, prothrombin time (PTI),activated partial thromboplastin time (APTf), and D-dimer levelswere examined after the diagnosis was confirmed by morphology andimmunophenotyping studies on bone marrow specimens.Results Out of 22 subjects, 13 subjects had increased D-dimervalues. The median D-dimer level of this elevated group was 1,000(range 500-14, 700) n gfmL. In the acute myeloblastic leukemia(AML) patients, activation of coagulation was found in 7 out of 8subjects. The median D-dimer levels was 950 (range 100-14, 700)ng/mL. In the acute lymphocytic leukemia (ALL) patients, 6 outof 14 subjects had increased activation of coagulation with medianD-dimer level of 300 (range 100-3,800) ngfmL. Nine out of 10subjects with blast cells on peripheral blood smear had a medianD-dimer level of 1,000 (range 500-3,800) ng/mL. Both PT andAPTT were found normal in all subjects.Conclusion Activation of coagulation sys tem occurs at thetime of diagnosis as shown by increased D-dimer levels. Thecharacteristics of activation of coagulation system are differentbetween ALL and AML subjects, as well as between subj ects withpositive and negative blast counts on peripheral blood smears.Despite the increased activation of coagulation, PT and APTfremain normal.
Childhood non-Hodgkin’s lymphoma in Cipto Mangunkusumo Hospital, Jakarta: Outcome of treatment 2000-2005 Djajadiman Gatot; Teny Tjitrasari; Novie Amelia Chozie
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.185-8

Abstract

Background Childhood non-Hodgkin’s lymphoma (NHL) is the thirdmost common solid tumor in Cipto Mangunkusumo, Jakarta. Since1992 there was no national report on the survival of children withNHL. To continue our observation on the result of treatment of chil-dren with NHL in our institution, we briefly report the outcome therapyof children with NHL who were admitted to our hospital during 2000-2005.Objective All patients who were diagnosed as non-Burkitt type NHLbetween January 2000-December 2005 were included in the study.Data collected retrospectively from the Oncology Registration ofHematology-Oncology Division, Department of Child Health, CiptoMangunkusumo Hospital, including age, sex, primary site of tumor,histopathology type, staging, treatment response, and outcome.Results A total of 24 patients were available. Male:female ratiowas 1.8:1. The age range was from 9 months to 11 years (median6 years). The histological type consisted of LL (3) and non-LL (11).Ten out of 14 patients were diagnosed as advanced stages (stagesIII and IV), while the rest were in stage II. Primary tumor site in LLtype were the head and neck (1), mediastinum (1), and testis (1),while the non-LL type patients had more varied site. Overall sur-vival of NHL was 78.6%+4.7%.Conclusion The overall survival of childhood NHL patients treatedwith protocol in our institution is in the range of survival that hadachieved in other centers worldwide, even with advanced stage ofdisease.
Hemostatic abnormalities in children with thalassemia major and liver iron overload Pustika Amalia Wahidiyat; Stephen Diah Iskandar; Novie Amelia Chozie; Damayanti Sekarsari
Paediatrica Indonesiana Vol 58 No 4 (2018): July 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (217.634 KB) | DOI: 10.14238/pi58.4.2018.175-9

Abstract

Background Thalassemia major (TM) patients are susceptible to liver dysfunction due to iron deposition. Pediatric TM patients often present with bleeding. Blood loss necessitates transfusions, leading to increased iron absorption from the gut. Objective To study hemostatic abnormalities in children with TM and iron deposition in the liver. Methods This cross-sectional study involved 190 non-splenectomized children with TM. Liver iron deposition was evaluated using T2* MRI. Prothrombin time (PT), activated partial thromboplastin time (aPTT), and platelet counts were assessed from blood specimens. Results Most subjects were diagnosed with β-thalassemia and β-thalassemia/HbE. The majority of subjects were on deferiprone (DFP) treatment. Approximately 89.5% of subjects had liver iron overload. Prolongation of PT and aPTT, as well as thrombocytopenia were observed in 60%, 27.9%, and 19.5% of subjects, respectively. Prolonged aPTT and thrombocytopenia were observed three times more frequently in subjects with moderate - severe liver iron overload than in subjects with normal - mild liver iron overload (P=0.04 and 0.001, respectively). Conclusion Most TM subjects have liver iron overload ranging from mild to severe. Prothrombin time and prolongation, as well as aPTT prolongation, and thrombocytopenia are easily found in TM children. There were significantly more moderate - severe liver iron deposition patients with aPTT prolongation and thrombocytopenia than normal – mild patients with these conditions. Hence, we suggest that pediatric TM patients undergo liver iron deposition evaluations and use iron chelators in an optimal manner, in order to limit the risk of bleeding.
Short-term intermittent prophylaxis post-intracranial hemorrhage in children with hemophilia Novie Amelia Chozie; Fitri Primacakti; Made Citra Saraswati; Damayanti Sekarsari
Paediatrica Indonesiana Vol 62 No 3 (2022): May 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.3.2022.174-9

Abstract

Background Intracranial hemorrhage (ICH) is one of the major bleeding events causing mortality and long-term morbidity in children with hemophilia, especially those who receive on-demand therapy. Objective To evaluate the outcome of children with hemophilia after ICH receiving short-term intermittent prophylactic treatment. Methods This retrospective study was conducted in the Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Jakarta. Children £18 years of age with hemophilia presenting with ICH between 2015-2020 were included. We recorded patients’ demographics, type and severity of hemophilia, the presence of factor VIII (FVIII) inhibitor, brain CT scan, treatment, and outcomes of these patients. Patients who received short-term intermittent prophylaxis using clotting factor concentrate (CFC) post-ICH episodes were observed for ICH recurrence. Results There were 19 episodes of ICH experienced by 18 patients, consisting of 16 patients with hemophilia A and 2 with hemophilia B. Patients’ median age was 4 years (range 0-16 years). Hemophilia was classified as severe in 13 patients, moderate in 4 patients, and mild in 1 patient. Thirteen episodes were preceded by head trauma. The most common clinical manifestation was seizures (13.2%). The most common type of ICH was subdural hematoma. Two patients died and 2 patients had neurological sequelae during hospitalization. The median dose of short-term intermittent prophylaxis using CFC (n=16) was 20 IU/kg of FVIII twice a week and 30 IU/kg of FIX twice a week, for a median duration of 8 weeks (range 5-12 weeks). One patient who did not adhere to the prophylaxis regimen had recurrent ICH at a similar location 6 months after the first episode. Conclusion Our findings suggest that short-term intermittent prophylaxis is important to prevent the recurrence of ICH in children with hemophilia.
Translation, cultural adaptation, and validation of the Indonesian version of Pediatric Quality of Life Inventory Rheumatology Module (PedsQL-RM) questionnaire for children with rheumatic diseases Ganda Ilmana; Zakiudin Munasir; Novie Amelia Chozie; Bernie Endyarni Medise
Paediatrica Indonesiana Vol 63 No 3 (2023): May 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.3.2023.136-45

Abstract

Background Quality of life is an important outcome in the management of children with chronic conditions such as rheumatic diseases. The Pediatric Quality of Life Inventory Rheumatology Module (PedsQL-RM) questionnaire has been proven valid and reliable, but a validated Indonesian version of the questionnaire is not yet available. Objective To translate the PedsQL-RM into the Indonesian language, perform a transcultural adaptation, and assess its validity. Methods A cross-sectional study was performed in patients aged 2 to 18 years with systemic lupus erythematosus (SLE) or juvenile idiopathic arthritis (JIA) in Dr. Cipto Mangunkusumo Hospital, Jakarta. The initial phase of the study consisted of forward translation from the original English version into Indonesian, synthesis by experts, backward translation, and cognitive debriefing, resulting in the final version of the questionnaire. The second phase was testing the final questionnaire on patients in each age group and their parents. Tests were carried out in two sessions with an interval of 2 to 4 weeks. The questionnaire consisted of a child report and a parent report, each measuring five dimensions: pain and hurt, activities, treatment, worry, and communication. We subsequently assessed validity and reliability of each dimension in the child and parent reports for the child and teen age groups. Validity was expressed as correlation coefficient (r) between dimension scores with the total score. Results The finalized Indonesian questionnaire was completed by 53 children aged 2-18 years with SLE or JIA and their parents. Due to small numbers of subjects in the younger age ranges, analysis was only performed in the 8-to-18-year age group. Validity varied from good to very good (r = 0.437 to 0.910) for the child report and from poor to good (r = 0.153 to 0.808) for the parent report. The questionnaire was deemed reliable, with a Cronbach’s alpha of 0.755 to 0.785. Conclusion The Indonesian version of the PedsQL-RM is valid and reliable for assessing quality of life in children aged 8 to 18 years with rheumatologic disease. Further study is needed to assess the validity and reliability of the tool for children aged 2 to 7 years.
Co-Authors Abigail, Dina Clarisa Rumora Antonius H Pudjiadi, Antonius H Aryono Hendarto Atmakusuma, Tubagus Djumhana Badriul Hegar Bernie Endyarni Medise Damayanti Sekarsari Djajadiman Gatot Djajadiman Gatot Djajadiman Gatot Fauzia, Sri Novia Fitri Primacakti Fitri Primacakti, Fitri Ganda Ilmana Harun Wijaya Ina Susianti Timan Made Citra Saraswati Marcel Prasetyo Marsubrin, Putri Maharani Tristanita Mulya Rahma Karyanti, Mulya Rahma Murti Andriastuti, Murti Nadia Devina Esmeralda Nia Kurniati Pustika Amalia Wahidiyat Raisa Cecilia Sarita Reza, Maulana Okta Rosyady, Maulana Santoso, Dara Ninggar Santoso, Novianti Saraswati, Made Citra Sarita, Raisa Cecilia Setyanto, Darmawan Budi Soebadi, Amanda Stephen Diah Iskandar Syahminar Rahmani Teny Tjitra Sari Teny Tjitrasari Wiharta, Fitri Primacakti Yoga Devaera, Yoga Yogi Prawira, Yogi Yuniasti Evitasari Zakiudin Munasir