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All Journal Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Majalah Kedokteran Sriwijaya Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Mediarty Syahrir
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Profile of Coagulation Marker and The Influence Factors in Central Nervous System Tumor Yunni Diansari; Mediarty Syahrir; Sri Novianty Yusuf
Majalah Kedokteran Sriwijaya Vol 53, No 2 (2021): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/mks.v53i2.10065

Abstract

Brain tumors have the highest percentage of thrombosis compared to other types of malignancies. Hypercoagulation is a risk for thromboembolic events in patients with malignancy. Hypercoagulation conditions are frequently found in patients with malignancy arising from the aptitude of tumor cells to activate the coagulation system. This condition can be detected through coagulation markers in the blood. This marker is PT, APTT, INR, Fibrinogen and D-Dimer. This research is a descriptive analytic study using secondary data from medical records of patients with central nervous system (CNS) tumors. The inclusion criteria were CNS tumor patients > 18 years old and had been diagnosed with CNS tumor. Coagulation markers are recorded based on the results of the initial laboratory examination upon entering the hospital, consisting of D-Dimer, PT, APTT, Fibrinogen, INR. There were 124 research subjects, consisting of 60 men and 64 women. Most research subjects are in the age range of 40-49 years (54.8%). Hypercoagulation conditions were found in 92.74% of study subjects. The most common accompanying condition was hypertension (22.6%). There were no significant differences in the hypercoagulable conditions in groups with and without accompanying conditions. Hypercoagulation was found in most research subjects. There are no factors that influence the hypercoagulation condition in this study.
Profile of Coagulation Marker and The Influence Factors in Central Nervous System Tumor Yunni Diansari; Mediarty Syahrir; Sri Novianty Yusuf
Majalah Kedokteran Sriwijaya Vol 51, No 4 (2019): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v51i4.10071

Abstract

Brain tumors have the highest percentage of thrombosis compared to other types of malignancies. Hypercoagulation is a risk for thromboembolic events in patients with malignancy. Hypercoagulation conditions are frequentlyfound in patients with malignancy arising from the aptitudeof tumor cells to activate the coagulation system. This condition can be detected through coagulation markers in the blood. This marker isPT, APTT, INR, Fibrinogen and D-Dimer.This research is a descriptive analytic study using secondary data from medical records of patients with central nervous system (CNS) tumors. The inclusion criteria were CNS tumor patients> 18 years old and had been diagnosed with CNS tumor. Coagulation markers are recorded based on the results of the initial laboratory examination upon entering the hospital, consisting of D-Dimer, PT, APTT, Fibrinogen, INR.There were 124 researchsubjects, consisting of 60 men and 64 women. Most research subjects are in the age range of 40-49 years (54.8%). Hypercoagulation conditions were found in 92.74% of study subjects. The most common accompanying conditionwas hypertension (22.6%). There were no significant differences in the hypercoagulable conditions in groups with and without accompanying conditions.Hypercoagulation was found in most research subjects. There are no factors that influence the hypercoagulation condition in this study.
THE COMPARISON OF EFFECTIVENESS AND SAFETY BETWEEN WARFARIN AND RIVAROXABAN IN HYPERCOAGULATED CENTRAL NERVOUS SYSTEM TUMORS Sri noviyanty Yusuf; Yunni Diansari; Mediarty Syahrir; Phey Liana
Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Vol. 11 No. 1 (2023): Jambi Medical Journal: Jurnal Kedokteran dan Kesehatan
Publisher : FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS JAMBI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22437/jmj.v11i1.25056

Abstract

Abstract:                                                                                                                                           Background: Central nervous system (CNS) tumors originate from the brain and spinal cord, and have complications, such as hypercoagulation. The administration of anticoagulants (warfarin and rivaroxaban) has been able to reduce hypercoagulation-related morbidity and mortality, however, the effectiveness and safety of their use has not been well studied. This study aims to compare the effectiveness and safety of anticoagulant drugs between warfarin and rivaroxaban in hypercoagulated CNS tumors. Methods: This was a randomized clinical trial study, double-blinded, conducted on CNS tumor patients from September-November 2020 at Mohammad Hoesin Hospital. The patients were given warfarin and rivaroxaban for 3 weeks. Coagulation status was measured before and after. Data were analyzed using SPSS ver.24. Results: The mean age of 20 patients was 42.70+8.14 years and majority were female (80%), with tumor characteristics were primary (80%), single (85%), and located in the brain (95%). In the warfarin group (n=10), there were significant improvements in PT (p 0.008), INR (p 0.013), Fibrinogen (p 0.041), and D-Dimer (p 0.008) value, also the rivaroxaban group (n=10) in PT (p 0.013), APTT (p 0.012), INR (p 0.028), Fibrinogen (p 0.047), D-Dimer (p 0.032), and Anti Fxa (p 0.028). However, there was no significant difference between groups, except when comparing the Anti Fxa delta (p 0.041). There was 1 person with major bleeding using warfarin, and 1 person (excluded) with GIT bleeding using rivaroxaban. Conclusion: There was a significant improvement of coagulation value in both groups, also side effects were seen as well. Keyword: CNS Tumor, Hypercoagulation, Warfarin, Rivaroxaban
Papillary Renal Cell Carcinoma Type 1 Accompanied by Hemorrhagic Anemia: A Case Report Mulia, Deddy Primadona; Zulkhair Ali; Novadian Suhaimi; Suprapti Slamet; Ian Effendi; Syahpri Putra Wangsa; Kgs. M. Yusuf Arief Akbar; Mediarty Syahrir; Fadil Pramudhya Hoesain; Ika Kartika
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 11 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i11.888

Abstract

Background: Kidney cancer or renal cell carcinoma (RCC) accounts for 5% and 3% of all adult malignancies in men and women, respectively, thus representing the 7th most common cancer in men, and the 10th most common cancer in women. The incidence of kidney cancer in the last two decades has shown an increase, but in recent years the death rate due to kidney cancer has decreased because it is increasing. Case Presentation: A 27 year old male patient came with complaints of bloody urination. Patients also complain of body weakness. Every time they are active, the weakness decreases if the patient rests. The patient was stated to be suffering from anemia and a left kidney tumor. There was bilateral antebrachial pitting edema. There was bilateral pretibial edema. Cytological examination revealed papillary renal cell carcinoma type 1. Conclusion: Papillary cell carcinoma type 1 is a kidney tumor that has a good prognosis, especially if found at an early stage. The classic symptoms of type 1 pRCC are anemia, hematuria and kidney swelling.
Targeting the TGF-β Pathway to Overcome Resistance to Immune Checkpoint Inhibitors in Microsatellite Stable Metastatic Colorectal Cancer: A Systematic Review and Pooled Analysis of Efficacy and Tumor Microenvironment Modulation Aprizal Satria; Norman Djamaludin; Yenny Dian Andayani; Mediarty Syahrir
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (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.v9i9.1395

Abstract

Background: The clinical utility of immune checkpoint inhibitors (ICIs) in metastatic colorectal cancer (mCRC) is restricted to a minority of tumors with mismatch repair deficiency. The vast majority, classified as microsatellite stable (MSS), display profound resistance driven by an immunosuppressive tumor microenvironment (TME) orchestrated by transforming growth factor-β (TGF-β). This study aimed to synthesize the evidence for combining TGF-β pathway inhibitors with ICIs to reverse this resistance. Methods: A systematic search of PubMed, Embase, Cochrane Library, and major oncology conference abstracts was conducted through December 2024 for preclinical and clinical studies evaluating TGF-β inhibition combined with ICIs in CRC. Due to the non-randomized nature of the clinical evidence, a pooled analysis of the single-arm objective response rate (ORR) was performed using a random-effects model. Progression-free survival (PFS), duration of response (DoR), and TME modulation were synthesized narratively. Results: Seven studies (four preclinical, three early-phase clinical) met the inclusion criteria. In the pooled analysis of 218 patients with predominantly MSS-mCRC from three clinical trials, the combination therapy yielded a pooled ORR of 14.2% (95% Confidence Interval [CI]: 9.1% – 20.2%), with moderate heterogeneity (I² = 38%). This represents a clinically meaningful improvement over the expected <1% response rate to ICI monotherapy in this population. Narrative synthesis of survival data indicated a median PFS ranging from 2.5 to 3.7 months and a promising median DoR exceeding 10 months in responders. Preclinical data consistently demonstrated that combination therapy synergistically inhibited tumor growth by remodeling the TME, marked by increased CD8+ T-cell infiltration and reduced stromal fibrosis. Conclusion: This systematic review and pooled analysis provide the most current synthesis of evidence for targeting the TGF-β pathway in MSS-mCRC. While preliminary and based on early-phase trials, the data show that this combination strategy can induce durable responses in a subset of patients by promoting an inflamed TME. These findings strongly support the continued investigation of this approach in biomarker-driven, randomized controlled trials.
Targeting the TGF-β Pathway to Overcome Resistance to Immune Checkpoint Inhibitors in Microsatellite Stable Metastatic Colorectal Cancer: A Systematic Review and Pooled Analysis of Efficacy and Tumor Microenvironment Modulation Aprizal Satria; Norman Djamaludin; Yenny Dian Andayani; Mediarty Syahrir
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (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.v9i9.1395

Abstract

Background: The clinical utility of immune checkpoint inhibitors (ICIs) in metastatic colorectal cancer (mCRC) is restricted to a minority of tumors with mismatch repair deficiency. The vast majority, classified as microsatellite stable (MSS), display profound resistance driven by an immunosuppressive tumor microenvironment (TME) orchestrated by transforming growth factor-β (TGF-β). This study aimed to synthesize the evidence for combining TGF-β pathway inhibitors with ICIs to reverse this resistance. Methods: A systematic search of PubMed, Embase, Cochrane Library, and major oncology conference abstracts was conducted through December 2024 for preclinical and clinical studies evaluating TGF-β inhibition combined with ICIs in CRC. Due to the non-randomized nature of the clinical evidence, a pooled analysis of the single-arm objective response rate (ORR) was performed using a random-effects model. Progression-free survival (PFS), duration of response (DoR), and TME modulation were synthesized narratively. Results: Seven studies (four preclinical, three early-phase clinical) met the inclusion criteria. In the pooled analysis of 218 patients with predominantly MSS-mCRC from three clinical trials, the combination therapy yielded a pooled ORR of 14.2% (95% Confidence Interval [CI]: 9.1% – 20.2%), with moderate heterogeneity (I² = 38%). This represents a clinically meaningful improvement over the expected <1% response rate to ICI monotherapy in this population. Narrative synthesis of survival data indicated a median PFS ranging from 2.5 to 3.7 months and a promising median DoR exceeding 10 months in responders. Preclinical data consistently demonstrated that combination therapy synergistically inhibited tumor growth by remodeling the TME, marked by increased CD8+ T-cell infiltration and reduced stromal fibrosis. Conclusion: This systematic review and pooled analysis provide the most current synthesis of evidence for targeting the TGF-β pathway in MSS-mCRC. While preliminary and based on early-phase trials, the data show that this combination strategy can induce durable responses in a subset of patients by promoting an inflamed TME. These findings strongly support the continued investigation of this approach in biomarker-driven, randomized controlled trials.
Co-Authors Aprizal Satria Fadil Pramudhya Hoesain Ian Effendi Ika Kartika Kgs. M. Yusuf Arief Akbar Mulia, Deddy Primadona Norman Djamaludin Novadian Suhaimi Phey Liana Sri Novianty Yusuf Sri noviyanty Yusuf Suprapti Slamet Syahpri Putra Wangsa Yenny Dian Andayani Yunni Diansari Zulkhair Ali