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All Journal Sari Pediatri Paediatrica Indonesiana Indonesian Journal of Cancer eJournal Kedokteran Indonesia

Murti Andriastuti, Murti

Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universiatas Indonesia/RS. Cipto Mangunkusumo, Jakarta

Author-ID : 565479

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Risk factors of coronary heart disease in children and young adults with parental history of premature coronary heart disease Murti Andriastuti; Sudigdo Sastroasmoro; Agus Firmansyah
Paediatrica Indonesiana Vol 43 No 2 (2003): March 2003
Publisher : Indonesian Pediatric Society

Background Morbidity and mortality of coronary heart disease(CHD) are recently increasing. This is related to changes in lifestyle,such as lack of activity and high consumption of fatty diet. Themain cause of CHD is atherosclerosis. The development of ath-erosclerosis takes a long time, is asymptomatic, and might beginin childhood. The important risk factors that have roles in increas-ing the likelihood of atherosclerosis are family history of prematureCHD, hypertension, hyperlipidemia, obesity, smoking and irregu-lar activity.Objective The aim of this study was to find out the prevalence ofCHD risk factors in children and young adults who had parentalhistory of premature CHD.Methods This was a descriptive cross sectional study conductedon offspring of premature CHD patients who were admitted in theintensive cardiology care unit (ICCU) of Cipto MangunkusumoHospital between January 1999 to December 2001 and of prema-ture CHD patients who visited the Cardiology Clinic of the Depart-ment of Internal Medicine, Cipto Mangunkusumo Hospital duringMarch and April 2002. Subjects were aged 12 to 25 year-old.Results Among the subjects, 40% had hyperlipidemia, 8% hadhypertension, 11% were obese, 21% were active smokers, 41%were passive smokers, and 73% had irregular activity. Ninety-sevenpercents subjects had more than 1 risk factors.Conclusions The prevalence of hyperlipidemia, hypertension,obesity, passive smoker, active smoker and irregular activity inchildren and young adults with parental history of premature CHDin this study were higher than those in the normal population.Most had more than 1 risk factor, increasing the likelihood of CHD.A screening test should be performed on children with parentalhistory of premature CHD so that early preventive measures mightbe done to minimize the risk factors

Red Blood Cell Transfusion for Pediatric Autoimmune Hemolytic Anemia in an Emergency Situation Murti Andriastuti; Ni Ken Ritchie; Kartika Anastasia Kosasih; Fakhri Muhammad; Anisa Dwi Fathinasari; Djajadiman Gatot
eJournal Kedokteran Indonesia Vol 9, No. 3 - Desember 2021
Publisher : Faculty of Medicine Universitas Indonesia

Autoimmune hemolytic anemia (AIHA) is often presented with severe anemia. Currently, several centers in Indonesia use washed red blood cells (RBCs) to transfuse AIHA patients. However, washed RBCs are not widely available, causing a delay in therapy. We herein report two cases of pediatric AIHA who presented with severe anemia with hemoglobin level of 4.1 g/dL and 5.3 g/dL. Both patients were delayed for two and five days to be given blood transfusion because of the unavailability of washed RBC in Sorong General Hospital and Fatmawati Hospital and must wait to be referred to RSCM to receive washed RBCs. We conducted literature searches to review several articles that focus on AIHA transfusion management. AIHA is characterized by the production of autoantibodies directed against antigens on the surface of RBCs. RBC washing is not currently required in AIHA patients. It is also not widely available, takes a long time to process, and can cause a delay in emergency cases. Although RBC transfusion is not contraindicated in AIHA, its use should be limited to life-threatening cases of anemia with signs of cardiac and neurological compromises. In emergency cases, ABOmatched and Rhesus-matched RBCs can be safely administered if alloantibodies are reasonably excluded based on the previous transfusion and pregnancy history. ABO-matched and Rh-matched RBC transfusion is safe as AIHA’s transfusion management for patients with severe anemia with clinical symptoms.

Peran Pelayanan Paliatif dan Suportif pada Pasien Kanker Anak Murti Andriastuti
Sari Pediatri Vol 25, No 4 (2023)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.4.2023.278-82

Kanker masih menjadi penyebab kematian utama pada anak. Angka kesintasan pasien kanker anak di negara berkembang masih jauh di bawah angka kesintasan pasien kanker anak di negara maju. Banyak faktor yang memengaruhi perbedaan tersebut, antara lain belum tersedianya sarana pengobatam transplantasi sumsum tulang sebagai opsi dalam tata laksana lanjutan kanker anak sehingga sangat penting peran pelayanan paliatif dan suportif dalam menunjang kualitas hidup pasien. Pelayanan paliatif dan suportif berfokus pada penanganan gejala akibat penyakit dan terapi yang diberikan untuk memberikan kenyamanan dan meningkatkan kualitas hidup pasien dengan pendekatan holistik. Perlunya pemahaman yang baik mengenai pelayanan paliatif dan suportif, kolaborasi dari berbagai pihak (multidisiplin) menjadi hal penting dalam memberikan pelayanan paliatif dan suportif yang optimal bagi pasien kanker anak dan keluarganya.

Family functioning, parental cancer-related emotions, and quality of life in childhood cancer patients Andriastuti, Murti; Fathinasari, Anisa Dwi; Arafah, Nurani Rahma; Asa, Annisa Aditya; Salsabila, Khansa; Primacakti, Fitri
Paediatrica Indonesiana Vol. 64 No. 3 (2024): May 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.3.2024.250-7

Background Childhood cancer and its treatment affects not only children’s health, but also children’s and families’ psychosocial function, relationship, emotion, and quality of life. Several studies in developed countries have been conducted to address this issue using the Family Adaptation and Cohesion Scales (FACES) III and the Situation-Specific Emotional Reaction Questionnaire (SSERQ). Screening psychosocial problems is crucial as part of cancer comprehensive care. Objective To investigate the dynamics of family functioning, parental cancer-related emotions, and to evaluate possible associations with the child's quality of life. Methods This cross-sectional study was done in child with cancer aged 0-18 years. Parents completed the validated Indonesian versions of three sets of questionnaires regarding subjects’ quality of life (PedsQL), family function (FACES III), and family cancer-related emotions (SSERQ). Validity and reliability tests were done to assess the Indonesian versions of the questionnaires. Results A total of 269 subjects were recruited. Parental proxy of PedsQL evaluations revealed that the 8-12-year-old age group had significantly lower score than the other groups (P=0.014). Solid tumor subjects had significantly lower PedsQL score compared to subjects with hematological malignancy (P=0.001). The FACES III questionnaire results showed that connected families tended to have better PedsQL score based on children’s evaluation compared to disengaged families (P=0.049). No significant difference was found between adaptability of family function and PedsQL score. The SSERQ revealed significant associations between negative emotions and lower PedsQL scores in the children (all P=0.000). Conclusions Parental proxy of PedsQL scores were significantly lower in older children (8 to 12 years). Children with connected families have significantly higher PedsQL scores than disengaged families, for the PedsQL children’s evaluation. Parents’ emotions (loneliness, helplessness, and uncertainty) experienced by a family member of a child with cancer are also correlated with lower PedsQL scores by both evaluations.

Pengaruh Kombinasi Terapi Akupunktur dan Medikamentosa Terhadap Keberhasilan Terapi Nyeri Kanker pada Anak Tyas, Nike Estu Renaning; Jusuf, Ahmad Aulia; Andriastuti, Murti; Djaali, Wahyuningsih
Sari Pediatri Vol 26, No 4 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.4.2024.236-43

Latar belakang. Di Amerika Serikat, kanker anak mencakup 2% dari seluruh kasus kanker. Kemajuan protokol terapi dalam beberapa tahun terakhir telah meningkatkan prognosis pasien kanker anak secara signifikan, tetapi juga memunculkan masalah baru, seperti nyeri kanker. Nyeri yang tidak tertangani dapat menurunkan kualitas hidup, mengganggu tidur, meningkatkan sensitivitas nyeri, dan menyulitkan tindakan medis. Akupunktur terbukti efektif sebagai terapi tambahan bersama pengobatan farmakologis untuk mengatasi nyeri kanker, sekaligus mengurangi dosis analgetik dan efek sampingnya.Tujuan. Tujuan dari penelitian ini adalah untuk mengetahui penggunaan obat analgetik, perubahan skor Visual Analog Scale S intra kelompok, dan keberhasilan terapi pada kelompok akupunktur dan medikamentosa dan kelompok medikamentosa saja pada nyeri kanker anak. Metode. Penelitian ini menggunakan desain kohort retrospektif dengan mengambil data di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo. Populasi terjangkau penelitian ini adalah pasien anak dengan nyeri kanker yang dirawat di Gedung Pusat Kesehatan Ibu Anak RSCM Kiara pada bulan Januari 2022- Juli 2023. Hasil. Kedua kelompok dapat menurunkan skor VAS dan terdapat beda signifikan. Akupunktur dan medikamentosa mempunyai peluang untuk dapat mengurangi penggunaan jenis obat analgetik, penggunaan ekstra obat dan pengurangan dosis total morfin harian, namun diperlukan penelitian lebih lanjut. Kedua kelompok memberikan hasil yang baik pada luaran keberhasilan terapiKesimpulan. Akupunktur dan medikamentosa mempunyai peluang untuk dapat mengurangi obat analgetik, mengurangi skor VAS, dan memberikan hasil yang baik untuk keberhasilan terapi, namun diperlukan penelitian lebih lanjut.

Performance of WHO mid-upper arm circumference cut-off to diagnose severe acute malnutrition in under-fives Neldy, Fahreza Aditya; Yuliarti, Klara; Andriastuti, Murti
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.439-46

Background Many studies indicate that the current WHO recommendation of cut-off value mid-upper arm circumference (MUAC) is not sensitive to detect severe acute malnutrition (SAM) in under-fives cases. Various new cut-off values have been proposed with better diagnostic values but have a wide interval, 12.1 cm—14.5 cm, which may be due to different races or habitus. Objective To evaluate the diagnostic value of MUAC in diagnosing SAM compared to the weight for height Z score (WFZ) index, to evaluate sensitivity, specificity, positive and negative predictive value of MUAC with 11.5 cm as standard cut-off, and to find an alternative cut-off value that may offer better diagnostic performance. Methods We collected 421 subjects consecutively in January-February 2020 in Cipto Mangunkusumo Hospital and Puskesmas Cengkareng. We performed brief conversations for demographic data and did the measurement of physical examination and anthropometric measurement by trained researchers and research assistants. Results Mid-upper arm circumference has excellent diagnostic value to assess SAM in under-fives with area under curve 0,939 (CI95% 0,903-0,974). Diagnostic values MUAC using cut off 11.5 cm were 21% sensitivity (Se) 21%, 99.7% spesificity (Sp)and Youden Index (YI) of 0.20. By using 13.3 cm as a new cut-off value, MUAC has Se 89%, Sp 87%, and YI of 0.76. Conclusion We conclude that WHO MUAC cut-off using 11.5 cm has lower performance to detect SAM cases than the proposed new cut-off value of 13.3 cm. New MUAC cut-off should be considered to detect more SAM cases among under-fives.

Unveiling the Survival Gap: Addressing the Challenges of Acute Lymphoblastic Leukemia in Adolescents Aisyi, Mururul; Kosasih, Agus Susanto; Utomo, Ahmad Rusdan Handoyo; Saputra, Fahreza; Sari, Teny Tjitra; Sjakti, Hikari Ambara; Dwijayanti, Fifi; Harimurti, Kuntjoro; Andriastuti, Murti
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1396

Background: Acute Lymphoblastic Leukemia (ALL) remains the most common pediatric cancer, yet survival outcomes vary widely across age groups. In Indonesia, comprehensive data on ALL survival rates are sparse, particularly for adolescents who often fare worse than younger children. The underlying factors contributing to the difference in adolescent survival rates still need to be fully understood. This study aimed to evaluate and compare the survival rates of children and adolescents with ALL treated at Dharmais Cancer Hospital.Method: We conducted a retrospective cohort analysis of 94 ALL patients, including 37 adolescent patients and 71 patients with B-lineage ALL. All patients with ALL from 2021 to 2023 were identified. Children aged 1–18 years, diagnosed with ALL based on bone marrow results and not yet treated, are included in the study. Patients were stratified by risk stratification (Standard Risk [SR] vs. High Risk [HR]), lineage (B-lineage vs. T-lineage), and age group (children under 10 vs. adolescents 10 years and above). The survival curve was analyzed using the KaplanMeier method, and the log-rank test was used to assess and compare survival across groups.Results: The overall survival (OS) rate for ALL patients was 49.5%. Adolescents had a significantly lower OS rate of 23.2% compared to children. SR patients exhibited an OS rate of 95.7%, while HR patients had a 33.3%. B-cell lineage had a higher OS rate (59.8%) than T-cell lineage (15.9%). In B-cell ALL, OS was 61.4% in children but only 28.1% in adolescents. Conclusion: The survival rate for adolescents with acute lymphoblastic leukemia (ALL) is significantly lower than that of children, influenced by risk stratification, lineage, and age. Further research is needed to identify these risk factors through genetic and molecular analyses.Conclusion: The survival rate for adolescents with acute lymphoblastic leukemia (ALL) is significantly lower than that of children, influenced by risk stratification, cell type, and age. Unexplained factors, including lineage differences, remain a challenge in adolescents. Further research into genetic and molecular factors is essential to enhance treatment precision and improve survival rates for ALL patients in Indonesia, especially adolescents.Keywords: Overall Survival, Leukemia, Adolescent ALL, Stratification

Associations between genomic copy number alterations and clinical and laboratory results in pediatric B-cell acute lymphoblastic leukemia Aisyi, Mururul; Andriastuti, Murti; Kosasih, Agus Susanto; Utomo, Ahmad Rusdan Handoyo; Saputra, Fahreza; Sari, Teny Tjitra; Sjakti, Hikari Ambara; Dwijayanti, Fifi; Harimurti, Kuntjoro
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.89-95

Background Copy Number Alterations (CNAs) are changes in DNA structure that lead to gain or loss of copies of DNA sections in the genome. They correlate with unfavorable prognostic outcomes in pediatric leukemia, influencing treatment resistance, relapse rates, and overall survival. Identifying high-risk patients with a likelihood of CNA positivity is essential for understanding its association with clinical characteristics and laboratory findings. Since routine CNA testing is costly, recognizing simple clinical and laboratory markers that predict CNA presence can help focus screening efforts, enabling more efficient risk stratification and prognosis assessment in acute leukemia Objective To describe the characteristics and analyze for associations between CNA, clinical characteristics, and laboratory findings in pediatric ALL patients. Methods This cross-sectional observational study included B-cell acute lymphoblastic leukemia (ALL) patients from three hospitals, excluding those above 18 years. Data collected encompassed demographics, clinical features, and laboratory results. We performed multiplex ligation-dependent probe amplification (MLPA) testing to identify CNA positivity. Results From January to December 2019, there were 74 pediatric ALL patients incuded in our study; 26 of them had positive results and the remaining 48 had negative results. CNA-positive status was commonly found in subjects aged ? 5 years (38.6%), while CNA-negative status was highest in patients aged ? 10 years (72.7%). CNA-positive status was significantly higher in patients with lymphadenopathy, lower hemoglobin level (7.73 g/dL), and lower platelet level (52,019/µL) (P<0.05). Conclusion Patients with lymphadenopathy, lower hemoglobin, and lower platelet levels are more likely to test positive for CNA. However, more research is needed to fully understand the implications of this finding and its potential impact on patient care.

Pemberian Suplementasi Besi dalam Upaya Mencegah Defisiensi Besi pada Bayi Prematur atau Berat Badan Lahir Rendah Aprilia, Yonita; Andriastuti, Murti
Sari Pediatri Vol 25, No 5 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.5.2024.333-40

Latar belakang. Besi merupakan mineral esensial yang dibutuhkan tubuh untuk menjalankan fungsi fisiologis. Defisiensi besi didefinisikan sebagai penurunan total kandungan besi dalam tubuh yang ditandai dengan turunnya kadar feritin atau saturasi transferin. Bayi prematur termasuk ke dalam kelompok berisiko untuk terjadinya defisiensi besi.Tujuan. Memberikan bukti ilmiah pemberian suplementasi besi pada bayi prematur atau berat badan lahir rendah untuk mencegah defisiensi besi.Metode. Pencarian literatur dengan instrumen pencari Pubmed dan Cochrane Library pada bulan Juli 2020.Hasil. Studi oleh McCarthy dkk menggunakan metode telaah sistematis dengan melibatkan tiga studi dengan luaran menurunnya defisiensi besi. Salah satunya oleh Lundstorm dkk yang menyatakan bahwa bulan ketiga seluruh subyek di kelompok uji mencapai kadar serum feritin rata-rata 32 ng/ml ml dan kelompok kontrol mencapai kadar serum ferritin rata-rata 17 ng/ml (p<0,05). Kadar serum ferritin pada bulan keenam pemantauan kelompok uji adalah rata-rata 29 ng/ml dan kelompok kontrol adalah rata-rata <10 ng/ml (p<0,001). Pada studi Berglund dkk menyatakan terdapat peningkatan kadar serum ferritin dan saturasi transferin pada kelompok uji dibandingkan dengan kelompok kontrol tanpa suplementasi besi (nilai p<0,001).Kesimpulan. Suplementasi besi jangka panjang terbukti mencegah defisiensi besi pada bayi prematur atau bayi dengan berat badan lahir rendah.

Efikasi Pemberian Madu Sebagai Ajuvan dibandingkan Terapi Standar pada Pasien Anak dengan Mukositis Oral Pascakemoterapi: Sebuah Laporan Kasus Berbasis Bukti Nadia, Charisha; Andriastuti, Murti
Sari Pediatri Vol 27, No 6 (2026)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.6.2026.423-34

Latar belakang. Madu memiliki efek antimikrobial dan antioksidan, yang murah dan mudah untuk didapatkan, sehingga menjadi pilihan dalam terapi mukositis oral.Tujuan. Untuk mengetahui efikasi pemberian madu sebagai ajuvan dibandingkan terapi standar pada pasien anak dengan mukositis oral pascakemoterapi.Metode. Penelusuran literatur dilakukan secara ekstensif melalui pangkalan data (database) elektronik PubMed®, Cochrane Library®, ScienceDirect® dengan kata kunci meliputi: “honey” DAN “oral mucositis” DAN “chemotherapy” DAN (“children” ATAU “pediatric”).Hasil. Strategi penelusuran literatur menghasilkan dua artikel yaitu studi telaah sistematik dan meta-analisis oleh Hao dkk, tahun 2022, dan uji klinis acak tersamar tunggal oleh Badr, dkk. tahun 2023. Studi oleh Hao dkk memiliki kualitas studi yang diinklusi kurang baik, tetapi hasilnya waktu pemulihan mukositis oral pascakemoterapi/radioterapi pada kelompok intervensi secara signifikan lebih singkat dibandingkan kontrol dengan perbedaan rerata/mean difference (MD) -5.10 (IK 95% -0,91 – 0,61), p = 0,03. Studi oleh Badr, dkk. memiliki kualitas yang baik dengan hasil derajat berat mukositis oral secara signifikan menurun pada kelompok madu dibandingkan kontrol setelah pemberian hari ke-7 (MD 1,00±0,63 vs 2,50±0,71, p=0,019).Kesimpulan. Pemberian madu (madu biasa, komersial, sajian beku, dan madu Manuka) sebagai ajuvan memiliki luaran yang lebih baik dari segi waktu pemulihan dan derajat berat dibandingkan terapi standar pada anak dengan mukositis oral pascakemoterapi.

Co-Authors Agus Firmansyah Agus Susanto Kosasih, Agus Susanto Ahmad Aulia Amarila Malik Andi Ade WR Andry Juliansen Anisa Dwi Fathinasari Aprilia, Yonita Arafah, Nurani Rahma Asa, Annisa Aditya Dewi Kartika Dini Astuti Mirasanti Djajadiman Gatot Djajadiman Gatot Fakhri Muhammad Fathinasari, Anisa Dwi Fifi Dwijayanti Fitri Primacakti, Fitri H F Wulandari Hidra Irawan Satari Hikari Ambara Sjakti, Hikari Ambara I Dewa Gede Ugrasena Ika Maya Sandy Irawan Mangunatmadja Irma Nareswari Kartika Anastasia Kosasih Kuntjoro Harimurti Mardjanis Said Marissa Tania Stephanie Pudjiadi Miranti Fristy Medyatama Muchtaruddin Mansyur Mururul Aisyi Nadia, Charisha Nareswari , Irma Nastiti Kaswandani Neldy, Fahreza Aditya Ni Ken Ritchie Novie Amelia Chozie Pustika Amalia Wahidiyat Riadi Wirawan Rianto Setiabudy Rina Mutiara Rini Sekartini Salsabila, Khansa Saputra, Fahreza Shadrina, Arifah Nur Siti Ayu Putriasih Sri Wulandah Fitriani Sudigdo Sastroasmoro Sudung Pardede Syahminar Rahmani Teny Tjitra Sari, Teny Tjitra Tyas, Nike Estu Renaning Utomo, Ahmad Rusdan Handoyo Wahyuningsih Djaali Widodo Tirto Yuliarti, Klara

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