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All Journal The Indonesian Biomedical Journal Universa Medicina Cermin Dunia Kedokteran
Wiyarta, Elvan
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Morning hypertension for stroke and cardiovascular: clinical pearls for primary care Rasyid, Al; Wiyarta, Elvan
Universa Medicina Vol. 40 No. 3 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.270-278

Abstract

Hypertension is the world’s leading cause of mortality and morbidity. One of the phenomena that commonly occur in hypertensive as well as normotensive patients, is morning hypertension. Blood pressure (BP) follows a diurnal rhythm, reaching its highest level during the morning hours and dropping to the lowest level at midnight. Transient increases in BP in morning hypertension plus persistent stressors within 24 hours are thought to increase target organ damage and trigger cardiovascular events. Therefore, ambulatory BP monitoring or morning home BP monitoring is recommended as a strong predictor of cardiovascular events. There are two types of morning hypertension according to its underlying mechanisms; the first one is called nocturnal hypertensive morning hypertension, and the other one is morning-surge hypertension. Numerous studies have proved that this phenomenon often leads to several acute cardiovascular events, such as stroke, coronary artery disease, and peripheral artery disease. To prevent these complications, cost-effective management is needed, especially for identifying accurate diagnostic tools, as well as creating specific regimens. Therefore, to achieve appropriate management of hypertension, including morning hypertension, long-acting antihypertensive drugs should be used, at full doses and in the form of combination therapy. The clinical usefulness of antihypertensive drugs with specific mechanisms for morning BP or split or timed dosing of long-acting drugs in controlling morning BP remains under investigation. More studies are needed, especially looking for other clinical evidence of the benefits of lowering BP in the morning. Home BP monitoring is recommended as a good choice for BP measurements, especially in the primary care setting.
Differential Effects of Anthracycline-based Neoadjuvant Chemotherapy on Stromal and Intratumoral FOXP3+ Tumor-Infiltrating Lymphocytes in Invasive Breast Cancer of No Special Type Rustamadji, Primariadewi; Wiyarta, Elvan; Pramono, Meike; Maulanisa, Sinta Chaira
The Indonesian Biomedical Journal Vol 16, No 2 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i2.2828

Abstract

BACKGROUND: Neoadjuvant chemotherapy (NAC) plays a crucial role in the management of invasive breast cancer with no special type (IBC-NST), with the immune system's response to cancer heavily relying on the dynamics between tumor-infiltrating lymphocytes (TILs) and cancer cells. In this study, the differential effects of anthracycline-based NAC on stromal and intratumoral foxhead box P3 (FOXP3+) TILs expressions were specifically examined.METHODS: In this cross-sectional study, 32 IBC-NST samples were evaluated for pre- and post-NAC FOXP3+ TIL expression as well as the changes of FOXP3+ TIL expression. Comprehensive data collection regarding subjects' age, tumor size, grade, lymphovascular invasion, regional lymph node metastasis, and receptor status were conducted. Immunohistochemistry was utilized to quantify FOXP3+ TILs. The stromal, intratumoral and total FOXP3+ TILs expression were then analyzed.RESULTS: Significant reductions in FOXP3+ TIL expression post-NAC were observed, with stromal FOXP3+ TILs showing a median decrease of 3.6 units in subjetcs aged ≥50 years (p=0.013) and a median decrease of 13.2 units in subjects with tumors ≥5 cm after NAC (p=0.006). In contrast, intratumoral FOXP3+ TILs remained relatively stable, with minor changes. The total FOXP3+ TIL expression, combining stromal and intratumoral components, was significantly decreased with a median of 13.0 units decreased to 5.3 units (p<0.001).CONCLUSION: This study highlights the significant reduction in stromal FOXP3+ TIL expression after NAC treatment in IBC-NST subjects, in contrast to the relatively stable intratumoral FOXP3+ TILs. Understanding these differences may guide future therapeutic strategies and improve treatment outcomes for IBC-NST.KEYWORDS: biomarkers, chemotherapy, FOXP3, prognostic, response, lymphocyte 
Potensi Citicoline dalam Menghambat Penurunan Fungsi Kognitif pada Gangguan Kognitif Ringan: Laporan Kasus Berbasis Bukti Wiyarta, Elvan; Kristiawan, Febrilian; Sinaga, Gideon Hot Partogi
Cermin Dunia Kedokteran Vol 51 No 8 (2024): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i8.1210

Abstract

Background: Citicoline has been associated with the improvement of various neurological conditions. This article aims to explore the potential of citicoline in preventing cognitive decline in mild cognitive impairment (MCI). Methods: A comprehensive literature search was conducted through 10 databases. Studies selected should include adult with cognitive impairment using citicoline. Articles were selected according to specified inclusion and exclusion criteria. A critical review and Level of Evidence assessment is done. Results: From a total of 265 studies obtained, 15 were selected and analyzed. The results show that citicoline has the potential to prevent cognitive decline, in patients with MCI, Alzheimer’s disease, Parkinson’s disease, ischemic stroke, and also in healthy individuals. Although results were varied, citicoline has consistently shown significant improvements in Mini-Mental State Examination (MMSE) scores and other cognitive tests. Conclusion: Citicoline has a potential in preventing cognitive decline in MCI. More research is needed to understand its long-term effects and mechanism of action.
Co-Authors Al Rasyid Kristiawan, Febrilian Maulanisa, Sinta C. Pramono, Meike Primariadewi Rustamadji Sinaga, Gideon Hot Partogi