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All Journal Medicina journal of internal medicine E-Jurnal Medika Udayana Acta Interna : The Journal of Internal Medicine Indonesian Journal of Rheumatology Jurnal Penyakit Dalam Udayana Callosum Neurology Journal : Jurnal Berkala Neurologi Bali Oceana Biomedicina Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran Cermin Dunia Kedokteran COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat Oceana Biomedicina Journal MEDICINUS Cermin Dunia Kedokteran
Gede Kambayana
Departemen Ilmu Penyakit Dalam, FK Universitas Udayana/RSUP Sanglah, Denpasar, Bali, Indonesia
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Economics, Econometrics & Finance Education Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Fenomena raynaud sekunder pada seorang penderita kanker kolon I Gusti Agung Indra Adi Kusuma; Gede Kambayana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (421.144 KB) | DOI: 10.15562/ism.v11i3.801

Abstract

Introduction: Secondary Raynaud's phenomenon (RP) is a transient microvascular spasm associated with other etiologies with clinical features of triphasic manifestations. Malignancy is a rare cause of secondary RP. Case Report: A man, 46 years, came to Sanglah General Hospital with secondary RP and colorectal malignancy. Discoloration white at the distal digits of the right manus and digits 3-5 left and sometimes accompanied thick at the fingertips, involved proximal to the medial phalanges. Laboratory examination showed albumin 2.55 g / dL, globulin 2.12 g / dL, LDH 323 IU / L, CRP 6.5 mg / dL, CEA 5.83 ng / mL plain abdominal radiograph impression of thickening on the part of the wall and show colitis appearance, be suspected ileus in the upper left abdominal region. Base on histopathological examination, ascending colon presents well-differentiated adenocarcinoma, and abdominal CT shows liver metastases. Management of patients with secondary RP with lifestyle and pharmacological interventions and chemotherapy for colorectal adenocarcinoma as the underlying cause. Pharmacological therapy of RP with intraoral amlodipine Conclusion: Malignancy in this patient as a cause of RP and management is carried out to treat primary disease and Raynaud's  Pendahuluan:    Fenomena Raynaud (RP) sekunder merupakan vasokontriksi transien pada mikrovaskular dikaitkan dengan etiologi lain dengan gambaran manifestasi trifasik. Keganasan menjadi kausa yang jarang pada RP sekunder.Laporan Kasus: Seorang laki-laki, usia 46 tahun, datang ke RSUP Sanglah dengan RP sekunder dan keganasan kolorektal. Dengan pucat  pada distal digiti manus dekstra dan digiti 3-5 sinistra dan disertai kadang tebal di ujung jari, meliputi proksimal sampai  medial falang. Pemeriksaan laboratorium menunjukkan albumin 2,55 g/dL, dan globulin 2,12 g/dL, LDH 323 IU/L, CRP  6,5 mg/dL, CEA 5,83 ng/mL dengan foto polos abdomen kesan penebalan pada sebagian dinding usus menunjukkan suatu gambaran kolitis yang diduga ileus pada regio abdomen kiri atas, kolon asenden dengan gambaran well differentiated adenokarsinoma  pada hasil biopsi histopatologi dan CT abdomen menunjukkan metastasis pada hepar. Penatalaksanaan pasien RP sekunder dengan intervensi gaya hidup dan farmakologis serta kemoterapi untuk adenokarsinoma kolorektal sebagai penyebab dasar. Terapi farmakologis RP dengan pemberian amlodipin intra oral.Simpulan: Kondisi keganasan pada pasien sebagai kausa dari RP dan tatalaksana  pengobatan spesifik RP. 
NEUROMYELITIS OPTICA SPECTRUM DISORDER (NMOSD) DENGAN ANTIBODI AQP4 POSITIF Rima Febry Lesmana; Anak Agung Mas Putrawati Triningrat; Made Paramita Wijayanti; I Made Agus Kusumadjaja; Ida Ayu Sri Indrayani; Gede Kambayana
Callosum Neurology Vol 4 No 2 (2021): Callosum Neurology Journal
Publisher : The Indonesia Neurological Association Branch of Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29342/cnj.v4i2.138

Abstract

Background: Neuromyelitis optica (NMO) is an in?ammatory demyelinating autoimmune disease of the central nervous system that most commonly affects the optic nerves and spinal cord. Seropositive antiAQP4 differentiates NMO from MS and the presence of manifestation in the postrema, brainsteam or diencephalic areas extend to NMO Spectrum Disorder (NMOSD). Case Description: A 18 years old male complain sudden vision loss on his left eye since 2 weeks ago. The examination show the visual acuity on the right eye was 6/6 and LPBP on the left eye. Positive RAPD on the left eye, funduscopy and the OCT RNFL within normal limits. Head MRI focus orbita with contrast show optic neuritis. Patient was diagnosed with left eye retrobulbar optic neuritis and ONTT therapy was given. The visual acuity improved to 1/60 then therapy change to oral steroid. Four months later, the patient suddenly got vision loss on the right eye accompanied by paraparesis. The visual acuity on the right eye was NLP and the left eye was 1/300, with mid-dilated papil. The results of the OCT RNFL show on the right eye edema papil and left eye atrophy papil. An MRI of the head focus orbital and whole spain was reexamined followed by VEP examination and an AntiAQP4 which showed an NMOSD. He was given ONTT then continued with immunosuppressants. The visual acuity of the right eye improved to 3/60 and the left eye remained 1/300. Discussion: This patient first presented with complain on the left eye with clinical and supporting symptoms suggesting an optic neuritis. The presence of a new attack on the right eye with paraparesis is a clinical feature of NMO supported by MRI results and seropositive AQP4 indicates an NMOSD. Conclusion: Establishment of diagnosis and administration of therapy quickly and precisely can reduce the severity and risk of recurrence which leads to greater disability and blindness. Key Words: Neuromyelitis Optica, Neuromyelitis Optica Spectrum Disorder, AQP4
Keganasan Kolorektal dengan Fenomena Raynaud Sekunder Ni Made Dwi Adnyani; Ida Bagus Aditya Nugraha; Gede Kambayana
Cermin Dunia Kedokteran Vol 46 No 12 (2019): Kardiovakular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i12.396

Abstract

Penyakit Raynaud adalah penyakit vaskuler primer yang ditandai dengan spasme sementara pada arteri kecil dan arteriol, biasanya di jari tangan atau, yang lebih jarang, jari kaki. Penyebab penyakit Raynaud dapat primer atau sekunder; salah satu penyebab sekunder adalah proses keganasan. Dilaporkan kasus pada pasien laki-laki, usia 46 tahun, suku Jawa dengan fenomena Raynaud sekunder diduga akibat kanker kolorektal. Raynaud’s disease is a primary vascular disease characterized by temporary spasm of small arteries and arterioles, usually in fingers or, rarely, in toes. The cause of Raynaud’s disease can be primary and secondary; one of the secondary causes is malignancy. This is a case of a 46 year-old Javanese male with secondary Raynaud’s phenomenon associated with colorectal cancer.
The Impact of Starting Urate-Lowering Therapy (ULT) During A Gout Flare on The Ongoing Episode: A Systematic Review of Randomized Controlled Trials Yogiswara, Komang Satvika; Widhiarta, Putu Raka; Wiwekananda, Ketut Shri Satya; Paramaiswari, Ayu; Achadiono, Dedy Nurwachid; Kambayana, Gede; Kertia, Nyoman
Acta Interna The Journal of Internal Medicine Vol 13, No 1 (2024): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.101289

Abstract

Background. Gout is a prevalent form of arthritis caused by the accumulation of monosodium urate (MSU) crystals. Urate-lowering therapy (ULT) may be started once an acute flare has subsided to prevent the present episode from lasting longer. Nevertheless, ULT may be commenced during an acute flare-up in order to decrease the frequency of outpatient appointments and enhance patient adherence. The objective of this study was to conduct whether the commencement of urate-lowering therapy (ULT) during an acute gout flare is effective. Method. We performed a systematic review of articles published in MEDLINE, PubMed, Cochrane library, and EMBASE databases from 2018 to 2023. The search was limited to articles published in English, and RCTs in patients older than 18 years.Results and Discussions. Among 242 recorded studies, only four with 323 patients were eligible for this research. The treatment with Allopurinol began with a daily dose    of 100 mg for the initial 14 days, followed by an increase to a daily dose of 200 mg for     the subsequent 14 days. The reported time to resolution was 15.4 days for the group receiving allopurinol and 13.4 days for the group receiving the placebo. According to this review, the start of ULT (uric acid-lowering therapy) should be determined by sufficient anti-inflammatory measures. Commencing ULT during a gout flare has no impact on the intensity, duration, or likelihood of recurrence of the flare within the following 28 to 30 days.Conclusions. This study demonstrated that the commencement of urate-lowering therapy (ULT) during an acute gout flare did not result in a longer duration of the flare. Nevertheless, it is necessary to conduct a clinical  studies with a bigger sample size in order to validate this review.
Keganasan Kolorektal dengan Fenomena Raynaud Sekunder Ni Made Dwi Adnyani; Ida Bagus Aditya Nugraha; Gede Kambayana
Cermin Dunia Kedokteran Vol 46 No 12 (2019): Kardiovakular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i12.396

Abstract

Penyakit Raynaud adalah penyakit vaskuler primer yang ditandai dengan spasme sementara pada arteri kecil dan arteriol, biasanya di jari tangan atau, yang lebih jarang, jari kaki. Penyebab penyakit Raynaud dapat primer atau sekunder; salah satu penyebab sekunder adalah proses keganasan. Dilaporkan kasus pada pasien laki-laki, usia 46 tahun, suku Jawa dengan fenomena Raynaud sekunder diduga akibat kanker kolorektal. Raynaud’s disease is a primary vascular disease characterized by temporary spasm of small arteries and arterioles, usually in fingers or, rarely, in toes. The cause of Raynaud’s disease can be primary and secondary; one of the secondary causes is malignancy. This is a case of a 46 year-old Javanese male with secondary Raynaud’s phenomenon associated with colorectal cancer.
Karakteristik Pasien Rheumatoid Arthritis Di RSUP Prof. I.G.N.G Ngoerah Pada Tahun 2022-2023 Govindha, I Putu Aris; Kambayana, Gede; Kurniari, Pande Ketut; Tejawati, Dewa Ayu Kartika
COMSERVA : Jurnal Penelitian dan Pengabdian Masyarakat Vol. 5 No. 2 (2025): COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/comserva.v5i2.3184

Abstract

Rheumatoid Arthritis (RA) merupakan penyakit kronis yang menyebabkan inflamasi terutama pada sendi. Pada tahun 2019, World Health Organization (WHO) melaporkan bahwa 20% populasi dunia mengalami rheumatoid arthritis. Pengetahuan mengenai karakteristik pasien RA menjadi penting untuk menambah kecekatan dokter dalam mendiagnosis dan meningkatkan efektivitas penanganan pasien dengan RA. Metode Penelitian ini merupakan penelitian dengan rancangan deskriptif cross-sectional terhadap pasien Rheumatoid Arthrits yang datang ke RSUP Prof. I.G.N.G. Ngoerah Denpasar, Bali periode Januari 2022 – Desember 2023. Hasil Usia rata-rata partisipan adalah 52.6 tahun, dengan mayoritas (60.4%) berusia antara 45-70 tahun. Sebanyak 30.84% subjek menunjukkan tingkat keparahan rendah pada arthritis rheumatoid, sementara 41.12% menunjukkan tingkat keparahan sedang. Kondisi remisi tercatat pada 17.76% subjek, sementara tingkat keparahan tinggi hanya terdapat pada 2.8% subjek. Dalam pemeriksaan laboratorium, ditemukan bahwa rata-rata kadar hemoglobin dalam kisaran normal, sebesar 12.75 g/dL. Kadar CRP menunjukkan tingkat peradangan yang sedang, dengan rata-rata 14.4 mg/L. Selanjutnya, tingkat LED sebesar 27.8 mm/jam menandakan peradangan yang tinggi. Tingkat RF, meskipun bervariasi, menunjukkan nilai rata-rata sebesar 18.7 IU/mL. NLR, sebagai penanda peradangan sistemik, memiliki nilai rata-rata sebesar 3.2. Mayoritas subjek mendapatkan terapi metrotreksat sebanyak 41.12%. Kesimpulan Pemahaman yang lebih baik tentang patofisiologi dari RA, dan faktor-faktor yang berkontribusi pada perkembangan RA dalam populasi tertentu diperlukan untuk mengembangkan pencegahan yang sesuai pada RA.
The Role of Biologic Agent in The Management of Ankylosing Spondylitis : A Case Report Gede Dilajaya Robin; Gede Kambayana; Robin, Gede Dilajaya
MEDICINUS Vol. 38 No. 10 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/7nbqyy62

Abstract

Background: Ankylosing spondylitis (AS) is a chronic immune-related arthritis primarily affecting the spine, sacroiliac joints, and surrounding tissues. The estimated incidence of AS ranges from 1.30–1.56 million in Europe and from 4.63–4.98 million in Asia. However, data on the current prevalence of AS in Indonesia remains limited. Various treatmentmodalities are available, one of them are biological agents that play a significant role in managing disease progression and preventing complications. Case: A 25-year-old male presented with a four-year history of chronic back pain. Laboratoryresults showed an elevated C-reactive protein (CRP) level of 31.20 mg/dl. Pelvic and thoracolumbar X-ray showed kyphotic deformity, bamboo spine, and dagger spine appearance. The patient was diagnosed with high disease activity ankylosingspondylitis (ASDAS-CRP: 2.9). Initial treatment with nonsteroidal anti-inflammatory drug (NSAID) alone did not result in clinical improvement. Due to the severity of disease activity, combination therapy using NSAID and a tumor necrosis factor (TNF) inhibitor was used, and reported to give satisfactory clinical response. Additionally, patient also underwent corrective spinal surgery due to severe deformity. Conclusion: TNF inhibitors are currently considered as the first-line biological therapy in the management of ankylosing spondylitis, due to their superior efficacy and safety in controlling disease progression compared to other biological agents.
Co-Authors A Halim Achadiono, Dedy Nurwachid Adnyani, Ni Made Dwi Ali Djamhuri Anak Agung Mas Putrawati Triningrat Andisari, Hendrata Erry Andriyasa Andriyasa Andriyasa, Andriyasa Anna Ariane Anwar Santoso Awalia Awalia Ayu Paramaiswari Bagus Rhama Dwi Budi Darmawati Dwijo Anargha Sindhughosa Faisal Parlindungan Gede Dilajaya Robin Gede Putu Arsana Govindha, I Putu Aris Harry Isbagio Hendrata Erry Andisari I Gusti Agung Friskha Surya Putra I Gusti Agung Indra Adi Kusuma I Gusti Ngurah Wien Aryana I K Rina I Ketut Suastika I Nyoman Suarjana I.B. Aditya Nugraha Ida Ayu Sri Indrayani Ida Bagus Aditya Nugraha IGN Eka Imbawan Indrawan, IGNM Budiana Ketut Suega Laniyati Hamijoyo, Laniyati Made Agus Kusumadjaja Made Paramita Wijayanti Manaek, Andi Ni Ketut Donna Prisilia Ni Made Dwi Adnyani Ni Made Dwi Adnyani Ni Putu Dewi Indriyani Nugraha, I.B. Aditya Nyoman Kertia Pande Ketut Kurniari Prisilia, Ni Ketut Donna Putra, T R Putu Imayati Rakhma Yanti Hellmi Rima Febry Lesmana Robin, Gede Dilajaya Rudy Hidayat T R Putra T R Putra Tejawati, Dewa Ayu Kartika Tjokorda Raka Putra Tonny, Tonny Try Parama Arthika Widhiarta, Putu Raka Wira Gotera Wiwekananda, Ketut Shri Satya Yenny Kandarini Yogiswara, Komang Satvika Yuliandari KK, Cok Istri