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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Medica Hospitalia Bioscientia Medicina : Journal of Biomedicine and Translational Research
Rudiyuwono Raharjo
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Efek Eicosapentaenoic Acid terhadap CD8+ dalam darah pasien kanker payudara stadium III B yang mendapat kemoterapi Cyclophosphamide Adriamycin Fluorouracyl siklus pertama Rudiyuwono Raharjo; Darwito -; Edi Dharmana
Medica Hospitalia : Journal of Clinical Medicine Vol. 1 No. 1 (2012): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.612 KB) | DOI: 10.36408/mhjcm.v1i1.40

Abstract

Latar Belakang : Eicosapentaenoic acid (EPA) mempunyai efek sebegai imunomodulator dan meningkatkan status gizi terutama dalam kaitannya dengan tumor kakeksia pada penderita dengan keganasan, Tujuan penelitian ini adalah mengetahui pengaruh pemberian eicosapentaenoic acid (EPA) terhadap jumlah sel T CD8+ pasien duktus invasif kanker payudara yang menjalani kemoterapi. Metode : Penelitian eksperimental pada pasien wanita dengan karsinoma duktus invasif payudara stadium IIIB yang menjalani kemoterapi Cyclophosphamide Adriamycin Fluorouracyl (CAF) siklus I dibagi menjadi 2 kelompok : tanpa pemberian EPA (kontrol) dan diberikan EPA 225 gr/hari selama 21 hari (perlakuan). Jumlah sel T CD8+ dalam darah perifer pasien diukur sebelum dan sesudah 21 hari setelah terapi. Hasil : Empatpuluh pasien mendapat kemoterapi CAF siklus I, terdiri dari 20 orang kelompok perlakuan dan 20 orang kelompok kontrol. Jumlah sel T CD8+ setelah terapi pada kelompok perlakuan lebih tinggi secara bermakna 1131,7sel/µl (483 – 3506) dibanding kelompok kontrol 631,8 sel/µl (227 – 1616) ( p< 0,05) dan diperoleh selisih jumlah sel T CD8+ yang berbeda bermakna sebelum dan 21 hari setelah kemoterapi pertama pada kedua kelompok penelitian ( p<0,001). Kesimpulan : Suplementasi EPA meningkatkanjJumlah sel T CD8+ dalam darah perifer pasien karsinoma duktus invasif payudara stadium III B yang dilakukan kemoterapi. Kata kunci : karsinoma duktus invasif payudara, Eicosapentaenoic acid (EPA), kemoterapi, CD8+
Conservative versus Interventional Management of Ingested Straight Pins in Adolescent Females: A Retrospective Case Series Illustrating Guideline-Based Decision-Making Purnamasari, Primadita; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1436

Abstract

Background: The ingestion of sharp foreign bodies (FBs) in adolescents presents a critical management dilemma, balancing conservative observation against the risk of gastrointestinal perforation. In certain cultural contexts, the accidental ingestion of straight pins used for hijabs creates a unique patient cohort. This study aims to illustrate the practical, guideline-based application of divergent management strategies in these specific clinical scenarios. Methods: We conducted a retrospective case series of five female adolescents, aged 13 to 15 years, managed at a single tertiary center for accidental straight pin ingestion. Data on clinical presentation, radiological findings, management strategy (conservative versus endoscopic), and outcomes were extracted and analyzed. Management decisions were dictated by established international guidelines. Results: Three asymptomatic patients (60%) with pins located distal to the duodenum were managed conservatively and experienced spontaneous passage within 2-4 days. Two patients (40%) required therapeutic endoscopy. One underwent emergent removal for a proximally located pin causing respiratory symptoms. The other, despite being asymptomatic, underwent urgent intervention due to the development of a radiological "sentinel loop" and rising inflammatory markers, which revealed an impacted duodenal pin. No complications occurred in any patient. Conclusion: This series demonstrates that while active surveillance is a safe strategy for asymptomatic patients with distally located sharp FBs, clinical silence does not preclude impending complications. Subtle radiological findings, such as a sentinel loop, are crucial indicators that must prompt timely endoscopic intervention to prevent morbidity. The educational value lies in highlighting these critical decision-making triggers.
Beyond 'Blunt': A Pathophysiology-Guided Framework for Managing High-Risk Pediatric Foreign Body Ingestion Fatmala Haningtyas; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1443

Abstract

Background: Foreign body ingestion is a significant cause of pediatric morbidity. The traditional "blunt" classification is insufficient for risk stratification, as objects like magnets and impacted items pose distinct threats based on their intrinsic properties. This study analyzes how a pathophysiology-based approach, distinguishing active (magnetic) from passive (mechanical) injury mechanisms, guides clinical decision-making. Methods: We conducted a retrospective, descriptive case series at a tertiary pediatric surgical center, reviewing cases from January 2022 to December 2024. Five illustrative cases of high-risk blunt foreign body ingestion were selected to demonstrate the spectrum of management based on the object's potential for harm. Results: The series included five children (aged 3-7 years). A 7-year-old with a single gastric magnet retained for five days developed mucosal injury and required urgent endoscopic removal. A 5-year-old with a recently ingested solitary gastric magnet and a 3-year-old with an impacted pyloric pendant also underwent urgent endoscopic removal. A 6-year-old with a gastric coin had elective endoscopy due to socioeconomic factors. In contrast, a 5-year-old with a coin that passed the pylorus was managed conservatively with spontaneous passage. All patients had successful outcomes. Conclusion: The management of pediatric foreign body ingestion should be dictated by the object's pathophysiological potential for injury, not its shape. Understanding the difference between active magnet-induced pressure necrosis and passive mechanical impaction is paramount for applying guidelines effectively and preventing severe complications. This framework supports a necessary shift from shape-based to mechanism-based risk assessment.
Conservative versus Interventional Management of Ingested Straight Pins in Adolescent Females: A Retrospective Case Series Illustrating Guideline-Based Decision-Making Purnamasari, Primadita; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1436

Abstract

Background: The ingestion of sharp foreign bodies (FBs) in adolescents presents a critical management dilemma, balancing conservative observation against the risk of gastrointestinal perforation. In certain cultural contexts, the accidental ingestion of straight pins used for hijabs creates a unique patient cohort. This study aims to illustrate the practical, guideline-based application of divergent management strategies in these specific clinical scenarios. Methods: We conducted a retrospective case series of five female adolescents, aged 13 to 15 years, managed at a single tertiary center for accidental straight pin ingestion. Data on clinical presentation, radiological findings, management strategy (conservative versus endoscopic), and outcomes were extracted and analyzed. Management decisions were dictated by established international guidelines. Results: Three asymptomatic patients (60%) with pins located distal to the duodenum were managed conservatively and experienced spontaneous passage within 2-4 days. Two patients (40%) required therapeutic endoscopy. One underwent emergent removal for a proximally located pin causing respiratory symptoms. The other, despite being asymptomatic, underwent urgent intervention due to the development of a radiological "sentinel loop" and rising inflammatory markers, which revealed an impacted duodenal pin. No complications occurred in any patient. Conclusion: This series demonstrates that while active surveillance is a safe strategy for asymptomatic patients with distally located sharp FBs, clinical silence does not preclude impending complications. Subtle radiological findings, such as a sentinel loop, are crucial indicators that must prompt timely endoscopic intervention to prevent morbidity. The educational value lies in highlighting these critical decision-making triggers.
Beyond 'Blunt': A Pathophysiology-Guided Framework for Managing High-Risk Pediatric Foreign Body Ingestion Fatmala Haningtyas; Sigit Adi Prasetyo; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1443

Abstract

Background: Foreign body ingestion is a significant cause of pediatric morbidity. The traditional "blunt" classification is insufficient for risk stratification, as objects like magnets and impacted items pose distinct threats based on their intrinsic properties. This study analyzes how a pathophysiology-based approach, distinguishing active (magnetic) from passive (mechanical) injury mechanisms, guides clinical decision-making. Methods: We conducted a retrospective, descriptive case series at a tertiary pediatric surgical center, reviewing cases from January 2022 to December 2024. Five illustrative cases of high-risk blunt foreign body ingestion were selected to demonstrate the spectrum of management based on the object's potential for harm. Results: The series included five children (aged 3-7 years). A 7-year-old with a single gastric magnet retained for five days developed mucosal injury and required urgent endoscopic removal. A 5-year-old with a recently ingested solitary gastric magnet and a 3-year-old with an impacted pyloric pendant also underwent urgent endoscopic removal. A 6-year-old with a gastric coin had elective endoscopy due to socioeconomic factors. In contrast, a 5-year-old with a coin that passed the pylorus was managed conservatively with spontaneous passage. All patients had successful outcomes. Conclusion: The management of pediatric foreign body ingestion should be dictated by the object's pathophysiological potential for injury, not its shape. Understanding the difference between active magnet-induced pressure necrosis and passive mechanical impaction is paramount for applying guidelines effectively and preventing severe complications. This framework supports a necessary shift from shape-based to mechanism-based risk assessment.
Laparoscopic Cholecystectomy is Associated with Superior Clinical Outcomes in Pediatric Cholelithiasis: A 6-Year Comprehensive Surgical Outcome Analysis from Semarang, Indonesia Natasha Hartanto; Edwin Basyar; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1469

Abstract

Background: The incidence of pediatric cholelithiasis is increasing globally, driven primarily by the childhood obesity epidemic. In a nation of over 270 million people like Indonesia, with rising obesity rates, understanding the optimal surgical management is a national health priority. This study provides the first detailed, comparative surgical outcome analysis for pediatric cholecystectomy from a major Indonesian referral center. Methods: A retrospective cohort study of all pediatric patients (≤18 years) undergoing cholecystectomy from January 2019 to December 2024 was conducted. Data on preoperative demographics, clinical presentation, intraoperative variables (operative time, blood loss, conversion rate), and postoperative outcomes (length of stay, 30-day complications graded by Clavien-Dindo) were extracted. Laparoscopic (LC) and open cholecystectomy (OC) groups were compared using Mann-Whitney U and Fisher’s exact tests. Results: The cohort of 30 patients (70% female, mean age 12.0 years) had a 60% prevalence of overweight or obesity. Laparoscopy was the initial approach in 25 cases (83.3%), with one conversion to open surgery (4%). Compared to the OC group (n=6), the definitive LC group (n=24) demonstrated significantly superior outcomes: median operative time was shorter (72 vs. 115 minutes, p=0.004), median estimated blood loss was lower (15 vs. 80 mL, p<0.001), and median postoperative length of stay was significantly reduced (3 vs. 5 days, p=0.002). The postoperative complication rate was lower in the LC group (8.3% vs. 33.3%, p=0.14), with all complications being minor (Clavien-Dindo Grade I-II). Conclusion: Laparoscopic cholecystectomy is a safe, effective, and efficient procedure that provides superior clinical outcomes compared to the open approach in the Indonesian pediatric population. These findings provide robust local evidence to establish LC as the unequivocal standard of care and justify investment in minimally invasive surgical training and infrastructure to meet the rising burden of this disease.
Laparoscopic Cholecystectomy is Associated with Superior Clinical Outcomes in Pediatric Cholelithiasis: A 6-Year Comprehensive Surgical Outcome Analysis from Semarang, Indonesia Natasha Hartanto; Edwin Basyar; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1469

Abstract

Background: The incidence of pediatric cholelithiasis is increasing globally, driven primarily by the childhood obesity epidemic. In a nation of over 270 million people like Indonesia, with rising obesity rates, understanding the optimal surgical management is a national health priority. This study provides the first detailed, comparative surgical outcome analysis for pediatric cholecystectomy from a major Indonesian referral center. Methods: A retrospective cohort study of all pediatric patients (≤18 years) undergoing cholecystectomy from January 2019 to December 2024 was conducted. Data on preoperative demographics, clinical presentation, intraoperative variables (operative time, blood loss, conversion rate), and postoperative outcomes (length of stay, 30-day complications graded by Clavien-Dindo) were extracted. Laparoscopic (LC) and open cholecystectomy (OC) groups were compared using Mann-Whitney U and Fisher’s exact tests. Results: The cohort of 30 patients (70% female, mean age 12.0 years) had a 60% prevalence of overweight or obesity. Laparoscopy was the initial approach in 25 cases (83.3%), with one conversion to open surgery (4%). Compared to the OC group (n=6), the definitive LC group (n=24) demonstrated significantly superior outcomes: median operative time was shorter (72 vs. 115 minutes, p=0.004), median estimated blood loss was lower (15 vs. 80 mL, p<0.001), and median postoperative length of stay was significantly reduced (3 vs. 5 days, p=0.002). The postoperative complication rate was lower in the LC group (8.3% vs. 33.3%, p=0.14), with all complications being minor (Clavien-Dindo Grade I-II). Conclusion: Laparoscopic cholecystectomy is a safe, effective, and efficient procedure that provides superior clinical outcomes compared to the open approach in the Indonesian pediatric population. These findings provide robust local evidence to establish LC as the unequivocal standard of care and justify investment in minimally invasive surgical training and infrastructure to meet the rising burden of this disease.
The Clinical and Pathological Landscape of Pediatric Appendicitis in Central Java, Indonesia: A Retrospective Cohort Study Highlighting a High Burden of Delayed Diagnosis Dimas Susilo Waridiarto; Edwin Basyar; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1470

Abstract

Background: The timely diagnosis of pediatric appendicitis is a global challenge, particularly in low- and middle-income countries where health system barriers can lead to significant delays and increased morbidity. This study aimed to characterize the clinical and pathological presentation patterns of pediatric appendicitis at a major Indonesian referral center to identify evidence of diagnostic delay and to analyze associated surgical management trends. Methods: A retrospective cohort study was conducted at Dr. Kariadi General Hospital on all pediatric patients (n=52) who underwent appendectomy between January 2022 and December 2024. Data on demographics, definitive histopathological diagnoses, and surgical approaches were collected and analyzed. The manuscript was prepared in accordance with the STROBE guidelines for observational studies. Results: The cohort was predominantly male (63.4%), with a peak incidence in the 6–10 year age group (42.3%). The most striking finding was the histopathological diagnosis: a remarkable 48.0% of patients were diagnosed with chronic appendicitis with acute exacerbation, a strong indicator of delayed presentation. Minimally invasive surgery was performed in 48.0% of cases. While a significant association was observed between laparoscopic surgery and a shorter postoperative length of stay (p < 0.001), this finding was subject to significant confounding by indication. Conclusion: The exceptionally high prevalence of chronic exacerbated appendicitis is the principal finding of this study, serving as a powerful public health signal for systemic delays in the pediatric acute care pathway in this region. While minimally invasive surgery is associated with faster recovery, the more pressing priority is addressing the upstream factors—including public awareness and primary care referral systems—that lead to late surgical presentation and increased cumulative morbidity.
The Clinical and Pathological Landscape of Pediatric Appendicitis in Central Java, Indonesia: A Retrospective Cohort Study Highlighting a High Burden of Delayed Diagnosis Dimas Susilo Waridiarto; Edwin Basyar; Rudiyuwono Raharjo
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 12 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i12.1470

Abstract

Background: The timely diagnosis of pediatric appendicitis is a global challenge, particularly in low- and middle-income countries where health system barriers can lead to significant delays and increased morbidity. This study aimed to characterize the clinical and pathological presentation patterns of pediatric appendicitis at a major Indonesian referral center to identify evidence of diagnostic delay and to analyze associated surgical management trends. Methods: A retrospective cohort study was conducted at Dr. Kariadi General Hospital on all pediatric patients (n=52) who underwent appendectomy between January 2022 and December 2024. Data on demographics, definitive histopathological diagnoses, and surgical approaches were collected and analyzed. The manuscript was prepared in accordance with the STROBE guidelines for observational studies. Results: The cohort was predominantly male (63.4%), with a peak incidence in the 6–10 year age group (42.3%). The most striking finding was the histopathological diagnosis: a remarkable 48.0% of patients were diagnosed with chronic appendicitis with acute exacerbation, a strong indicator of delayed presentation. Minimally invasive surgery was performed in 48.0% of cases. While a significant association was observed between laparoscopic surgery and a shorter postoperative length of stay (p < 0.001), this finding was subject to significant confounding by indication. Conclusion: The exceptionally high prevalence of chronic exacerbated appendicitis is the principal finding of this study, serving as a powerful public health signal for systemic delays in the pediatric acute care pathway in this region. While minimally invasive surgery is associated with faster recovery, the more pressing priority is addressing the upstream factors—including public awareness and primary care referral systems—that lead to late surgical presentation and increased cumulative morbidity.
Co-Authors Darwito - Dimas Susilo Waridiarto Edi Dharmana Edwin Basyar Fatmala Haningtyas Natasha Hartanto Purnamasari, Primadita Sigit Adi Prasetyo