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George Pestalozi
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Education Medicine & Pharmacology Neuroscience Public Health

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Cystatin C sebagai Biomarker Fungsi Ginjal: Literature Review Pestalozi, George; Akbar, Fareel Wahyu; Ramadhian, Muhammad Ricky; Graharti, Risti; Lisiswanti, Rika
Medula Vol 14 No 10 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i10.1410

Abstract

Kidneys are the primary organs responsible for the excretion of metabolic waste products. Glomerular Filtration Rate (GFR) serves as a critical parameter for assessing renal function, with serum creatinine traditionally utilized as the primary biomarker. However, the accuracy of creatinine-based assessments is limited by its susceptibility to external variables, including age, sex, muscle mass, and dietary intake. These factors can lead to variability in results and reduce diagnostic precision. To overcome these limitations, cystatin C (CysC) has gained prominence as a superior alternative biomarker. Unlike creatinine, serum CysC levels are minimally influenced by external factors, offering greater stability and sensitivity in detecting acute kidney injury (AKI), chronic kidney disease (CKD), and other renal impairments such as diabetic nephropathy. Cystatin C provides notable advantages in the reclassification of CKD stages, particularly in cases where GFR measurements are borderline. CysC has demonstrated superior reliability over creatinine in predicting complications such as delayed graft function (DGF), a condition often necessitating hemodialysis. Preoperative measurement of CysC levels is instrumental in predicting long-term renal function and identifying patients at elevated risk for adverse outcomes. Elevated serum CysC concentrations in patients with renal cell carcinoma (RCC) have been correlated with poorer prognoses and an increased likelihood of postoperative renal injury. Despite its clinical advantages, the routine adoption of CysC is constrained by certain limitations. Chief among these is the significantly higher cost of CysC assays compared to traditional creatinine tests, which restricts its widespread application to confirmatory diagnostics or complex clinical scenarios.
Karsinoma Kolon Sigmoid dengan Metastasis Hepar: Analisis Klinis, Diagnostik, dan Penatalaksanaan Khalishah, Iffatunnada; Fathurrahman, Yusmaidi; Pestalozi, George
Medula Vol 16 No 1 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i1.1739

Abstract

Colorectal cancer is one of the most common cancers affecting the colon or rectum, with prevalence continuing to increase. In Indonesia, this cancer is ranked fourth with more than 34,000 new cases in 2020. The main risk factors for colorectal cancer include a diet high in fat and low in fiber, age over 50 years, and a family history of colorectal cancer. Symptoms often involve changes in bowel patterns, blood in the stool, abdominal pain, and unexplained weight loss. In more advanced cases, intestinal obstruction or metastasis to other organs, including the liver, may occur. This article reviews a case of a 57-year-old female patient who came with complaints of difficulty defecating accompanied by blood in the stool, abdominal pain, and weight loss. Based on the results of physical examination, laboratory, and other supporting examinations such as colonoscopy and histopathology, colorectal cancer with liver metastases was diagnosed. Treatment is carried out with fluid therapy, symptomatic treatment, and Hartmann procedure surgery to remove the sigmoid colon mass. A patient's prognosis is influenced by the stage of the cancer, with advanced stages having a poor prognosis. This research aims to increase knowledge about colorectal cancer and emphasize the importance of early detection and a multidisciplinary approach to treating colorectal cancer.
The The Role of Glucosamine and Chondroitin Supplementation in the Management of Osteoarthritis. Febriantara, M.Kaisar; Pestalozi, George; Ismunandar, Helmi
Medula Vol 16 No 2 (2026): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v16i2.1808

Abstract

Osteoarthritis (OA) is a chronic degenerative disease characterized by progressive damage to articular cartilage and surrounding joint tissues, clinically manifesting as pain, deformity, and disability. The main risk factors include aging, joint injury or overuse, and obesity. According to the Global Burden of Disease Study in 2020, approximately 595 million people worldwide were living with osteoarthritis. In Indonesia, data from the 2018 Basic Health Research report indicated that osteoarthritis affected about 55 million individuals, with the highest prevalence among those aged over 61 years, accounting for 65%. Pathophysiologically, osteoarthritis develops due to cartilage thinning, leading to biomechanical changes, reduced synovial fluid, and increased inflammatory processes associated with aging. Inflammatory cells, particularly macrophages, release mediators that accelerate cartilage degradation and exacerbate joint pain. Radiological assessment of osteoarthritis severity is commonly performed using the Kellgren–Lawrence classification. Management of osteoarthritis frequently involves nonsteroidal anti inflammatory drugs, although long term use is associated with adverse effects. Therefore, adjunctive therapies such as glucosamine and chondroitin have been widely studied. Glucosamine and chondroitin exhibit anti inflammatory and chondroprotective effects and play roles in inhibiting cartilage degradation while supporting anabolic processes in cartilage tissue. Several studies have demonstrated that supplementation with glucosamine and chondroitin improves pain scores, slows joint space narrowing, and enhances joint function in patients with osteoarthritis. These findings suggest that glucosamine and chondroitin may serve as beneficial adjunctive therapies in the management of osteoarthritis.
Tinjauan Literatur Sistematis: Protokol Kriptografi untuk Menjamin Keamanan dan Privasi Data Genomik Wijaya, Angga; Idris, Mohamad; Septiani, Linda; Pestalozi, George
Medula Vol 15 No 4 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i4.1840

Abstract

precision medicine. However, the static and hereditary nature of genomic data poses significant privacy risks for individuals and their families. This article aims to conduct a systematic literature review of various modern cryptographic protocols designed to protect genomic data. The research method utilizes a Systematic Literature Review (SLR) approach, analyzing relevant literature from 2018 to 2026. The findings indicate that protocols such as Homomorphic Encryption (HE) and Secure Multi-party Computation (SMPC) offer robust protection but face challenges regarding computational efficiency and bandwidth. Differential Privacy (DP) provides an efficient alternative but carries risks of reduced data accuracy. In conclusion, securing genomic data requires hybrid models that integrate algorithmic efficiency with long-term resilience, particularly against quantum computing threats. Aligning these technologies with Indonesia's Personal Data Protection Law (UU PDP) is crucial for building a secure and credible national health data ecosystem.
Co-Authors Akbar, Fareel Wahyu Angga Wijaya, Angga Fathurrahman, Yusmaidi Febriantara, M.Kaisar Helmi Ismunandar Idris, Mohamad Khalishah, Iffatunnada Muhammad Ricky Ramadhian Rika Lisiswanti Risti Graharti Septiani, Linda