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Raymond R. Tjandrawinata
School of Bioscience, Technology and Innovation, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Jantung yang Tidak Tahu Sedang Diobati: Kardiotoksisitas Anthracycline dan Urgensi Kardio-Onkologi Raymond R. Tjandrawinata
MEDICINUS Vol. 39 No. 6 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/49s0cn95

Abstract

Anthracycline-based chemotherapy has long been a cornerstone in the management of various malignancies, however, this antineoplastic class carries a frequently under-recognized consequence in the form of subclinical cardiac injury thatdevelops long before clinical manifestations become apparent. Cardiotoxicity mediated by topoisomerase IIβ dysregulation and oxidative stress does not occur abruptly, but cumulatively, with an incidence of approximately 9% among exposed populations. The physiological paradox further complicates this phenomenon, as compensatory mechanisms may mask ongoing myocardial damage, allowing early intervention window to be frequently missed. This article argues that the traditional boundaries between oncology and cardiology are no longer sufficient, and that an integrated cardio-oncology approach, incorporating active cardiac surveillance as soon as the initiation of therapy, should be regarded as clinical necessity rather than merely a consultative option.
Ansietas pada Lansia: Prevalensi, Faktor Penanda, dan Penanganannya Raymond R. Tjandrawinata
MEDICINUS Vol. 39 No. 2: MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/qefshn93

Abstract

Anxiety in older adults is a prevalent mental health issue, yet it is frequently underrecognized due to the overlap symptoms with physical illnesses and age-related psychosocial changes. This article reviews the global prevalence, key risk markers,and evidence-based management approaches. Numerous studies indicate that anxiety in older adults is associated with chronic medical conditions (including pain), functional gastrointestinal disorders such as irritable bowel syndrome (IBS),low level of physical activity, and unhealthy dietary patterns. Evidence regarding direct association between serum vitamin D levels and anxiety in older adults remains inconsistent; however, emerging evidence suggests an indirect associationmediated through the role of vitamin D in gastrointestinal health and inflammatory process. Management of anxiety in older adults is recommended to follow a biopsychosocial approach, prioritizing psychological interventions such as cognitive behavioral therapy (CBT) and lifestyle modification, and selective pharmacotherapy reserved for moderate to severe cases.
Disfagia dalam Perspektif Klinis Kontemporer Raymond R. Tjandrawinata
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/r1kbev80

Abstract

Dysphagia is a clinical symptom with diverse etiologies that is often narrowly interpreted as a neurological disorder or mechanical obstruction, however, recent literature indicates that it may present as a dominant symptom in chronictonsillopharyngitis with acute exacerbation. This narrative perspective review discusses the variability of dysphagia manifestations, underlying pathophysiological mechanisms, and the implications for management in inflammatorytonsillopharyngitis compared to dysphagia due to stroke, neurological, and neoplastic conditions, emphasizing that inflammatory dysphagia related to tonsillopharyngitis is potentially reversible and gives favourable response to cultureguidedantibiotics, short-term corticosteroids, as well as dietary modification. Early recognition of these clinical variations is essential to improve diagnostic accuracy and patients’ quality of life.dysphagia, chronic tonsillopharyngitis, acute exacerbation, oropharynx inflammation, clinical management
Resistensi Insulin sebagai Poros Disfungsi Ovulasi pada Polycystic Ovary Syndrome Raymond R. Tjandrawinata
MEDICINUS Vol. 39 No. 5 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/wnqbb620

Abstract

Insulin resistance in polycystic ovary syndrome (PCOS) is intrinsic in nature and not merely a consequence of obesity. Postreceptorphosphorylation abnormalities, particularly excessive serine phosphorylation of the insulin receptor and insulin receptor substrate, impair the activation of PI3K/Akt pathway, resulting in compensatory hyperinsulinemia. This conditionstimulates CYP17A1 expression in ovarian theca cells, suppresses hepatic synthesis of sex hormone-binding globulin, and creates a hormonal milieu that disrupts follicular maturation, ultimately leading to oligo-anovulation. The improvementin ovulation reported with the use of glucagon-like peptide-1 (GLP-1) receptor agonists is better understood as an indirect consequence of systemic metabolic improvement. The bioactive fraction DLBS3233 acts at a more downstream level,restoring tyrosine phosphorylation and glucose transporter-4 (GLUT-4) expression by modulating peroxisome proliferatoractivated receptor (PPAR)-γ. Positioning insulin resistance as the central pathophysiological axis enables a more precisetherapeutic approach aligned with the physiological mechanisms underlying ovulatory dysfunction in PCOS.
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