Claim Missing Document
Check
Articles

Virus Hepatitis B Mutan Setyawan, Yuswanto
e-CliniC Vol 5, No 2 (2017): Jurnal e-CliniC (eCl)
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.5.2.2017.18461

Abstract

Abstract: It is estimated that there are two billions people ever infected by hepatitis B virus (HBV) and there are around 350 milllions people suffering from chronic hepatitis B; 20-25% of them are going to develop chronic liver diorders and hepatocellular carcinoma (HCC). Development in vaccination programs and therapy of hepatitis B infection might trigger the genom mutation in part of viral adaptation to stress (mutant HBV). The characteristic of mutant HBV cases is negative results of anti-HBs and HBsAg, meanwhile other infection markers showed the occurence of HBV infection. Antigenic determinant mostly used to detect this infection is determinant “a” of HbsAg located in the position of 124-127. Changes in that location will disturb detection of HbsAg caused by decreased reactivity against several comercial kits, therefore, the sensitivity will decrease and be undected. Mutant HBV causes difficulty in patient detection and evaluation of blood donor. Besides that, mutation will influence the result of vaccination or therapy due to uneffectiveness of several managements.Keywords: hepatitis B infection, vaccination and therapy, mutant HBV Abstrak: Diperkirakan sekitar 2 milyar penduduk pernah terinfeksi virus hepatitis B (HBV) dan saat ini sekitar 350 juta penduduk sedang menderita infeksi hepatitis B kronis dan 20-25% diantaranya akan berkembang menjadi penyakit hati kronis serta karsinoma hepatoseluler (HCC). Berkembangnya program vaksinasi serta berbagai terapi untuk infeksi hepatitis B memungkinkan timbulnya mutasi pada genomnya sebagai bagian dari adaptasi virus terhadap tekanan (HBV mutan). Karakteristik untuk kasus HBV mutan ini ialah negatifnya anti-HBs dan HBsAg, sednagkan petanda infeksi yang lain menunjukkan adanya infeksi HBV. Determinan antigenik yang banyak digunakan untuk mendeteksinya ialah determinan “a” dari HbsAg yang terletak di posisi 124-127. Perubahan pada daerah tersebut akan mengganggu deteksi adanya HbsAg, karena berkurangnya reaktivitas terhadap berbagai kit komersial sehingga sensitivitasnya menjadi semakin menurun yang berakibat tak terdeteksi. HBV mutan menyebabkan kesulitan pada deteksi penderita serta penapisan donor darah. Selain itu adanya mutasi akan berpengaruh pada hasil vaksinasi atau terapi karena menyebabkan tidak efektifnya berbagai penanganan yang dilakukan.Kata kunci: infeksi virus hepatitis B, vaksinasi dan terapi, HBV mutan
Nilotinib as the First Line Therapy in Managing Chronic Myelogenous Leukemia Setyawan, Yuswanto
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.32699

Abstract

Abstrak: Leukemia mieloid kronis (chronic myeloid leukemia/CML) adalah penyakit klonal dari sel induk hematopoietik, secara sitogenetik ditandai dengan adanya kromosom Philadelphia (t[9,22][q34;q11]), yang merupakan fusi BCR-ABL1 onkogen. Nilotinib, generasi kedua inhibitor kinase tirosin, merupakan turunan aminopirimidin yang menghambat aktivitas kinase tirosin protein BCR-ABL. Dengan aktivitas penghambatan yang 10-60 kali lebih besar daripada imatinib, pada terapi lini pertama standar untuk CML, nilotinib efektif untuk CML fase kronik dan akselerasi yang resisten terhadap imatinib, namun terapi kombinasi nilotinib dengan agen lainnya masih diperlukan untuk pasien dengan CML krisis blas. Nilotinib aktif terhadap beberapa mutan BCR-ABL yang resisten terhadap imatinib, kecuali mutan T315I. Mutasi spesifik E255K/V, Y253H/F, F359C/V, dan L248V umumnya kurang sensitif terhadap nilotinib. Sebagai terapi lini pertama pada pasien CML fase kronik dengan Ph+ yang baru terdiagnosis, nilotinib menunjukkan CCyR dan MMR yang lebih tinggi serta pengembangan menjadi fase akselerasi/krisis blas serta resiko kematian yang lebih rendah, bila dibandingkan dengan imatinib. Simpulan penelitian ini ialah nilotinib lebih unggul dibandingkan dengan imatinib sebagai terapi lini pertama pada pasien CML fase kronik dengan Ph+ yang baru terdiagnosis,Kata kunci: chronic myeloid leukemia (CML), nilotinib, imatinib, terapi lini pertama  Abstract: Chronic myeloid leukemia (CML) is a clonal disease of the hematopoietic stem cells, cytogenetically characterized by Philadelphia chromosome (t[9,22][q34;q11]) leading to the fusion of BCR-ABL1 oncogene. Nilotinib, the second-generation tyrosine kinase inhibitor (TKI), is an aminopyrimidine derivative that inhibits the tyrosine kinase activity of the chimeric protein BCR-ABL. Its inhibitory activity is 10-60 times that of imatinib, therefore, as the standard first-line therapy for CML, nilotinib is effective in the case of CML-CP and CML-AP with imatinib resistant or intolerant. Albeit, novel approaches with nilotinib-based combinations are required for patients in CML-BP. Nilotinib is active against several imatinib-resistant BCR-ABL mutants with the exception of T315I. Specific mutations that are less sensitive to nilotinib include E255K/V, Y253H/F, F359C/V, and L248V. As the first-line therapy of patients with newly diagnosed Ph+ CML-CP, nilotinib has higher rates of CCyR and MMR, lower rates of progression to AP or BC, and lower risk of CML related death when compared with imatinib. In conclusion, nilotinib is superior to imatinib as the the first-line therapeutic option in newly diagnosed Ph+ CML-CP patients.Keywords: chronic myeloid leukemia (CML), nilotinib, imatinib, first line therapy
Hipernatremia dan Penatalaksanaanya Setyawan, Yuswanto
Medical Scope Journal Vol 2, No 2 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.2.2.2021.32693

Abstract

Abstract: Hypernatremia could be caused by loss of water (increased loss or decreased intake), and although rarely, due to over intake of natrium. Patients who are at risk of hypernatremia are those with disturbance of thirst or limited access of water. Several factors that could cause hypernatremia especially among geriatric patients are, as follows: change of thirst stimuli, decreased ability to concentrate urine, and decreased total body water. Clinical signs of hypernatremia are usually not specific, however, patients tend to become symptomatic if hypernatemia occurs acutely. Hypernatremia clinical signs are mostly neurological related to the severity and the change of serum sodium concentration. Complications of hypernatremia are inter alia shrinkage of brain tissue due to the movement of water from intracellular to extracellular fluid which results in injury of brain vessels, bleeding in the brain, and a variety of neurological signs due to brain involovement which could lead to death. Management of hypernatremia has to be carried out accurately and thoroughly because inaccurate or too-rapid correction could risk the occurrence of cerebral edema.Keywords: hypernatremia, total body water  Abstrak: Hipernatremia dapat disebabkan oleh kehilangan air (peningkatan kehilangan atau penurunan asupan) dan, walaupun jarang, karena kelebihan asupan natrium. Yang berisiko tinggi untuk hipernatremia ialah mereka dengan gangguan mekanisme rasa haus atau keterbatasan akses terhadap air. Berbagai faktor dapat menyebabkan hipernatremia terutama pada geriatri seperti perubahan rangsangan haus, berkurangnya kemampuan pemekatan urin, dan berkurangnya total body water. Gejala klinis hipernatremia biasanya tidak spesifik namun pasien cenderung menjadi simtomatik saat hipernatremia terjadi secara akut. Gejala hipernatremia terutama bersifat neurologik terkait dengan tingkat keparahan dan kecepatan perubahan konsentrasi natrium serum. Komplikasi hipernatremia ialah antara lain penyusutan otak akibat perpindahan cairan intrasel ke ekstrasel yang dapat merobek pembuluh darah otak, pendarahan otak, dan berbagai gejala neurologik akibat keterlibatan otak, yang dapat berakhir fatal. Penatalaksanaan hipernatremia perlu dilakukan dengan cermat karena penanganan yang tidak tepat atau koreksi yang terlalu cepat dapat berisiko terjadinya edema serebri.Kata kunci: hipernatremia, total body water
Acute Kidney Injury in Critically Ill Patients Setyawan, Yuswanto
Medical Scope Journal Vol 3, No 1 (2021): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.3.1.2021.32694

Abstract

Abstrak: Gagal ginjal akut (GGA) sering ditemukan dalam praktek klinik namun diagnosisnya dapat tertunda oleh karena keterbatasan alat diagnostik. Dewasa ini, kriteria diagnostik RIFLE, AKIN, dan KDIGO untuk menilai adanya GGA dan keparahannya dianggap tidak cukup untuk menggambarkan kompleksitas sindrom GGA. Proteinuria dan mikroalbuminuria yang merupa-kan marker klasik progresi cedera ginjal kronik, telah dipergunakan dan divalidasi untuk progresi GGA ke CKD. Kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), dan urinary cystatin C dapat berperan dalam memrediksi pemulihan ginjal. Indikasi biopsi ginjal pada pasien kritis ialah gangguan ginjal yang tidak jelas atau progresi CKD dengan hematuria glomerulus dan proteinuria lebih dari 1 gram per hari, manifestasi ginjal dari penyakit sistemik yang mengancam nyawa, kecurigaan penolakan akut atau kronik dari ginjal transplan. Mempertahankan hemodinamik yang adekuat seharusnya bermanfaat dalam pence-gahan onset atau perburukan GGA, namun kelebihan cairan harus dihindari. Sampau saat ini penentuan saat inisiasi acute renal replacement therapy (ARRT) masih kontroversial, demikian pula nilai ambang spesifik untuk memulainya belum sepenuhnya disepakati. Kata kunci: gagal ginjal akut; penyakit kritis' laju filtrasi glomerulus (LFG)  Abstract: Acute kidney injury (AKI) is a common problem in clinical practice, but its diagnosis could be delayed due to the inherent limitation of current diagnostic tools. Current practice suggests that RIFLE, AKIN, and KDIGO diagnostic criteria used to assess the presence of AKI and its severity are insufficient to illustrate the complexity of the AKI syndrome. Proteinuria and micro-albuminuria, classical markers of chronic kidney disease (CKD) progression, have been used and validated for the progression of AKI to CKD. Kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and urinary cystatin C could play a role in prediction of renal recovery. Indication of renal biopsy in critically ill patients are unexplained renal impairment or progression of CKD with both glomerular hematuria and proteinuria more than 1 gr per day, renal manifestations of life threathening systemic disease, suspected acute or chronic rejection of a transplanted kidney. The maintenance of adequate hemodynamics should be beneficial in preventing the onset or the worsening of AKI, but fluid overload should be avoided. Timing of acute renal replacement therapy (ARRT) initiation is still controversial, moreover, specific thresholds for starting are still unclear.Keywords: acute kidney injury (AKI); critically ill; glomerular filtration rate (GFR)
Merokok dan Gangguan Fungsi Ginjal Setyawan, Yuswanto
e-CliniC Vol 9, No 2 (2021): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v9i2.33991

Abstract

Abstract: Smoking increases the production of angiotensin II as an effect of renin secretion stimulated by the efferent sympathetic system through beta-1 adrenergic stimulation of the juxtaglomerular apparatus. Angiotensin II will cause tubular and glomerular injuries through the mechanism of pressure-induced renal injury and ischemia-induced renal injury as a secondary result of intrarenal vasoconstriction and decreased renal blood flow. In addition, there is secondary tubular injury due to angiotensin-induced proteinuria. Angiotensin II activates renal fibroblasts to undergo differentiation into myofibroblasts, stimulates TGF-ß profibrotic cytokines, induces oxidative stress, stimulates chemokines and osteopontin which can cause local inflammation, and stimulates mesangial cell proliferation and hypertrophy. Glomerular capillary hypertension causes an increase in glomerular permeability resulting in an increase in albumin filtration which will further trigger kidney damage through various pathways, including induction of tubular chemokine expression and activation of complement leading to infiltration of inflammatory cells in the interstitium and trigger fibrogenesis. This phenomenon involves endothelial cells and glomerular podocytes and will trigger exacerbation of proteinuria and glomerulosclerosis with the end result in the formation of kidney scar tissue and a decrease in glomerular filtration rate (GFR).Keywords: smoking; renal function; TGF-ß; glomerular filtration rate (GFR)  Abstrak: Merokok akan meningkatkan produksi angiotensin II sebagai efek dari sekresi renin yang distimulasi oleh sistim simpatik eferen melalui stimulasi beta-1 adrenergik pada aparatus jukstaglomerular. Angiotensin II akan menyebabkan cedera tubulus dan glomerulus melalui mekanisme pressure-induced renal injury dan ischemia-induced renal injury sebagai akibat sekunder dari vasokonstriksi intrarenal dan penurunan aliran darah ginjal. Selain itu terjadi cedera tubulus sekunder dari proteinuria yang diinduksi angiotensin. Angiotensin II akan mengaktifkan fibroblas ginjal berdiferensiasi menjadi miofibroblas, menstimulasi sitokin profibrotik TGF-ß, menginduksi stres oksidatif, menstimulasi kemokin dan osteopontin yang dapat menyebabkan inflamasi local, dan menstimulasi proliferasi dan hipertrofi sel mesangial. Hipertensi kapiler glomerulus akan menyebabkan peningkatan permeabilitas glomerulus sehingga terjadi peningkatan filtrasi albumin yang selanjutnya memicu kerusakan ginjal melalui berbagai jalur, diantaranya induksi ekspresi kemokin tubulus dan aktivasi komplemen yang akan mengarah pada infiltrasi sel-sel inflamasi pada interstisium dan memicu fibrogenesis. Fenomena ini melibatkan sel endotel dan podosit glomerulus dan akan mencetuskan eksaserbasi proteinuria dan glomerulosklerosis dengan hasil akhir berupa terbentuknya jaringan parut ginjal dan penurunan laju filtrasi glomerulus (LFG).Kata kunci: merokok; fungsi ginjal; TGF-ß; laju filtrasi glomerulus (LFG)
PEMBEKALAN KLASIFIKASI BARU MAKHLUK HIDUP HEWAN KEPADA GURU-GURU BIOLOGI Hebert Adrianto; Yuswanto Setyawan; Dharma PP Banjarnahor; Irwin Priyatna Kusumah; Billy Daniel Messakh
Sebatik Vol 26 No 2 (2022): Desember 2022
Publisher : STMIK Widya Cipta Dharma

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46984/sebatik.v26i2.2152

Abstract

Klasifikasi adalah salah satu ilmu tertua dalam bidang biologi dimasa sebelum masehi (SM). Klasifikasi memiliki peran penting karena memudahkan manusia mempelajari makhluk hidup yang sangat banyak tetapi secara berkelompok. Posisi makhluk hidup didalam klasifikasi terus mengalami pergeseran seiring ditemukan teknologi yang lebih canggih dan detail hingga struktur yang mikroskopis. Materi klasifikasi adalah salah satu materi biologi yang dinilai sulit oleh siswa dan guru. Guru harus senantiasa mengikuti perkembangan zaman dan informasi terbaru di bidang biologi. Tujuan pengabdian ini adalah membekali pengetahuan baru bidang klasifikasi makhluk hidup kepada para guru biologi grup Ciputra. Kegiatan pengabdian ini dilaksanakan pada tanggal 28 Maret 2022 hingga 07 April 2022. Peserta kegiatan ini adalah para guru biologi grup Ciputra sebanyak 15 orang, baik jenjang Sekolah Menengah Pertama (SMP) maupun Sekolah Menengah Atas (SMA). Metode kegiatan dilakukan secara daring zoom dengan pendekatan ceramah, bedah jurnal, dan diskusi. Hasil kegiatan ini adalah kegiatan berjalan lancar dan diikuti oleh 15 orang (83,3%), peserta mendapatkan informasi terbaru dalam klasifikasi makhluk hidup, seperti filum dan subfilum dalam kingdom protozoa termasuk di dalamnya apicomplexa, filum cacing nematoda, filum brachiopoda, dan ordo insekta, peserta mampu mengambil keputusan ketika menemukan konsep yang berbeda antar literatur mengenai sistem klasifikasi makhluk hidup.
Pemantauan Paska Transplantasi Ginjal Yuswanto Setyawan
e-CliniC Vol. 11 No. 2 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i2.47631

Abstract

Kidney transplant recipients require unique medical care that includes attention not only to the function of the transplant itself, but also to common medical problems that are more prevalent, more atypical, and more severe in presentation than in the general population. Due to the successes of kidney transplantation, the estimated additional life-years gained from renal transplantation vary from 8 to 31 years. During the early phase, prevention of acute rejection and infection are the priority. After around 3–6 months, the priorities change to preservation of transplant function and avoiding the long-term complications of immunosuppressive medication (the medication used to suppress the immune system to prevent rejection). The potential complications discussed include heart disease, infection, cancer, bone disease and blood disorders. There is also a section on contraception and reproductive issues. In conclusion, the most important management of post kidney transplantation is prevention of acute rejection and opportunistic infections. Prognosis of kidney transplant recipient will worsen if both of the conditions mentioned occur. Keywords: kidney transplant recipients; post kidney transplantation; early phase prevention; long-term-complications   Abstrak: Resipien transplantasi ginjal memerlukan perawatan medis khusus yang memerlukan perhatian tidak hanya pada fungsi transplantasi itu sendiri, tetapi juga pada masalah medis umum yang sering timbul, atipikal, umumnya dengan presentasi yang lebih parah daripada populasi umum. Transplantasi ginjal yang berhasil dapat menambah usia harapan hidup yang bervariasi, berkisar delapan hingga 31 tahun. Selama fase awal prioritas penanganan ialah reaksi penolakan akut dan pencegahan infeksi. Setelah 3-6 bulan paska trasnplantasi, prioritas ialah mempertahankan fungsi transplantasi dan menghindari komplikasi jangka panjang dari pengobatan imunosupresif (obat yang digunakan untuk menekan sistem kekebalan, untuk mencegah reaksi penolakan). Potensi komplikasi yang dibahas meliputi penyakit jantung, infeksi, kanker, penyakit tulang, kelainan darah, kontrasepsi dan masalah reproduksi. Simpulan kajian ini ialah penatalaksanaan paska transplantasi ginjal yang paling penting berupa pencegahan penolakan akut dan infeksi oportunistik, dimana prognosis resipien transplantasi ginjal akan memburuk jika kedua kondisi tersebut terjadi. Kata kunci: resipien transplantasi ginjal; pasca transplantasi ginjal; pencegahan tahap awal; komplikasi jangka panjang
BIOMARKER PADA LUPUS NEFRITIS Gisela Tania Irwanto; Yuswanto Setyawan
Bahasa Indonesia Vol 4 No 2 (2023): Prominentia Medical Journal
Publisher : Universitas Ciputra Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37715/pmj.v4i2.4559

Abstract

Lupus nephritis (LN) continues to be a leading cause of high morbidity and mortality rates in systemic lupus erythematosus (SLE) patients. Kidney biopsy remains the gold standard for diagnosing LN. Several biomarkers have been identified and evaluated, contributing to improvements in the management of LN patients. This literature review summarizes recent relevant literature on biomarkers for the diagnosis, monitoring, and prognosis of LN. These biomarkers are categorized based on their sample sources, namely serum and urine. Both sample sources show significant variations in biomarker data associated with disease activity and histological parameters of LN. Potential biomarker molecules include antibodies, cytokines, chemokines, and adhesion molecules. This literature review provides a general overview and serves as a reference for further research, particularly in advancing the understanding of LN biomarkers in Indonesia. Keywords: systemic lupus erythematosus (SLE), lupus nephritis (LN), biomarkers, serum, urin
Pengayaan materi Biologi Seluler pada Komunitas Guru Biologi Adrianto, Hebert; Setyawan , Yuswanto; Banjarnahor, Dharma PP; Kusumah, Irwin Priyatna; Messakh, Billy Daniel
Jurnal Pengabdian Masyarakat: Humanity and Medicine Vol 4 No 1 (2023): Jurnal Pengabdian Masyarakat: Humanity and Medicine
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/Hummed.V4I1.112

Abstract

Cell biology in schools is important for higher education provision, but it is difficult material for students and teachers to learn because it is abstract. The purpose of this activity is to enrich the concept of cell biology for the Biology Teacher community in the Ciputra Education group. The activity method is carried out by the lecture and discussion method on the Zoom application. The activities proceed according to the agreed-upon schedule. This activity was attended by 15 biology teachers. The results of the activity were that the activity participants had received cellular biology material regarding the cell cycle and cell division, the physiology of sperm formation (spermatogenesis), and muscle contraction. Participants get Shutterstock images and videos from YouTube that have been selected to be used as teaching material in class. The participants' reflections after this activity were that they were able to connect the material with everyday life; Participants can relate the topic of cells to the topics of organ systems, cell metabolism, and genetic material in the biology curriculum for junior high and senior high schools; they were not confused that cell division is actually part of the stages of the cell cycle. Recommendations for further activities from the participants are that this activity will be held again with the topic of the relationship between cells and disease and that it is necessary to measure the participants' knowledge, and need to evaluate the benefits of these images and videos after being applied in class.
VITAMIN D PADA ASMA BRONKIAL Setyawan, Yuswanto
Bahasa Indonesia Vol 5 No 1 (2024): Prominentia Medical Journal
Publisher : Universitas Ciputra Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37715/pmj.v5i1.4487

Abstract

Bronchial asthma is a lung disease characterized by reversible airway obstruction both spontaneously and with treatment, characterized by airways inflammation and hyperreactivity to various stimuli. Until now, the most effective treatment for asthma are corticosteroids and β-agonists, while the administration of prophylactic drugs is often less effective and often causes very disturbing side effects. Vitamin D is a group of fat-soluble secosteroids. Vitamin D has functions in modulating neuromuscular function, reducing inflammation and influencing the work of various genes that regulate cell proliferation, differentiation and apoptosis. Research shows that low levels of vitamin D are associated with increased allergy markers and asthma levels. Vitamin D is believed to play a role in asthma by inhibiting respiratory tract smooth muscle proliferation via hyperphosphorylation of the retinoblastoma protein and activation of checkpoint kinase 1 (Chk1). Vitamin D has recently been considered as a treatment for asthma.