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All Journal Medical Journal of Indonesia The Indonesian Biomedical Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Cermin Dunia Kedokteran
Dicky Levenus Tahapary
Divisi Metabolik Dan Endokrin Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia-RSUPN Cipto Mangunkusumo
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Diagnosis and Management of Klatskin Tumor Dicky Levenus Tahapary; Rudy Hidayat; Achmad Fauzi; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 1, April 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/111201044-50

Abstract

Klatskin tumor is a cholangiocarcinoma in bifurcatio areas and related to poor prognosis. Surgery is the only curative method, but endoscopy also has a role in diagnostic as well as therapeutic measures. This report shall discuss a case of Klatskin tumor in which to establish diagnosis, multimodal imaging using ultrasonography, computed tomography, endoscopic retrograde cholangiopancreatography (ERCP), and tumor markers were used. For palliative therapeutic measures in this case, placement of plastic stents by ERCP was performed. The procedure ERCP with stents placement can be an option in the management of Klatskin tumor, in which surgery is not possible to be conducted. Keywords: Klatskin tumor, ERCP, stent, diagnosis, management
Association of Proprotein Convertase Kexin/Type 9 with Atherosclerosis in People with Type 2 Diabetes Mellitus: a Systematic Review Luthfia, Farissa; Wisnu, Wismandari; Tahapary, Dicky Levenus; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

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Abstract

Introduction. Type 2 diabetes melitus is the leading cause of cardiovascular event with high level of low-density lipoprotein as the main predictor marker of atherosclerosis. PCSK9 plays a role in LDL-receptor regulation, its association with atherosclerosis had been investigated but the result is inconsistent. This study aimed to examine the association between PCSK9 level and atherosclerosis in people with type 2 diabetes. Methods. A systematic review was done in July 18 – September 02, 2020 and registered in PROSPERO. Risk of bias of each study was analyzed with Newcastle Ottawa scale tools. Studies involved in this systematic review then narratively analyzed by two independent reviewers. Results. There are 430 subjects involved from 4 studies. Guo, et al. reported that there was a significant association between PCSK9 level with atherosclerosis in type 2 diabetes melitus (OR: 1.12 (CI 95% 1.041 – 1.204), p: 0.002), those association was also reported by Ma, et al. with p value Conclusions. There is still insufficient evidence that show the association between PCSK9 level and atherosclerosis in type 2 DM. Therefore, longitudinal primary research is needed.
Faktor-Faktor yang Memengaruhi Kualitas Hidup Pasien Gagal Jantung Kronik Fraksi Ejeksi Terjaga (HFpEF) Rawat Jalan di RSUPN Dr. Cipto Mangunkusumo Pratama, Derin Anugrah; Nasution, Sally Aman; Muhadi, Muhadi; Mansjoer, Arif; Alwi, Idrus; Purnamasari, Dyah; Lydia, Aida; Tahapary, Dicky Levenus
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. The prevalence of heart failure in Indonesian adults is 1.5%, at least half of which categorized as heart failure with preserved ejection fraction (HFpEF). Quality of life assessment plays an important role in the management of heart failure, one of the tools widely used is the Minnesota Living with Heart Failure (MLHF) questionnaire. In Indonesia, there is still no data regarding risk factors that affect the quality of life of HFpEF patients. This study aimed to determine the quality of life profile of HFpEF patients and the relationship between the risk factors (age, hypertension, DM, smoking, and obesity) on the quality of life of HFpEF patients. Methods. A cross-sectional study was conducted. Data was collected from adult HFpEF (based on echocardiography in the last 6 months) patients (>18 years old) who visited the Cardiology Clinic at Cipto Mangunkusumo Hospital from January 2022 to December 2023. Quality of life was measured using the MLHF questionnaire. Bivariate analysis was performed to find the relationship between risk factors (age, gender, hypertension, DM, smoking, and obesity) and patients’ quality of life. Multivariate analysis was performed for hypertension, DM, gender, and age variables. Results. Out of 206 subjects, 72.33% of patients were dominant in the physical domain items, and 27.67% of patients were dominant in the emotional domain items. The majority of patients dominant in physical items had overall good quality of life. The majority of patients dominant in emotional items also had good quality of life. No significant relationship was found between the dominant domain item and the quality of life in HFpEF patients. We also found that there was no significant relationship between socio-demographic factors and risk factors for dominant domain items. However, there was a significant relationship between age (p=0.005), gender (p=0.001), and smoking history (p=0.001) with the quality of life in HFpEF patients. Adult patients had a poorer quality of life compared to elderly patients (OR= 0.33 [95% CI 0.17-0.66]). No significant relationship was found between hypertension, diabetes mellitus, dyslipidemia, and obesity with the quality of life in HFpEF patients. Conclusions. There is a statistically significant relationship between age, gender, and smoking history with the quality of life in HFpEF patients. Meanwhile, there is no significant relationship between hypertension, diabetes mellitus, and obesity with the quality of life in HFpEF patients.
Reduced Population of CD36-/ABCA1+ Macrophages is Correlated with An Increase of Coronary Artery Disease Risk Markers in Type 2 Diabetes Mellitus Nur Irawati; Heri Wibowo; Ani Retno Prijanti; Rona Kartika; Dicky Levenus Tahapary
The Indonesian Biomedical Journal Vol 15, No 6 (2023)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v15i6.2625

Abstract

BACKGROUND: Cluster of differentiation (CD)36 and adenosine triphosphate-binding cassette transporter A1 (ABCA1) are 2 macrophages-expressed receptors that promote cholesterol uptake and efflux, in which their imbalance might be associated with the foam cell formation risk. Type 2 diabetes mellitus (T2DM) has been correlated with the increase of this plaque formation. Therefore, it is necessary to determine whether expression of CD36 and ABCA1 in macrophages are correlated with coronary artery disease (CAD) risk markers in T2DM cases.METHODS: Peripheral blood mononuclear cells (PBMC) were isolated from 13 diabetic patients and 11 healthy donors. Then, the PBMC-derived macrophages were cultured with supplement of oxidized low-density lipoprotein (ox-LDL) or lipopolysaccharide (LPS). Expression of CD36 and ABCA1 was measured using flowcytometry, meanwhile the supernatant concentration of interleukin (IL)-1b and IL-10 was measured by multiplex immunoassay.RESULTS: T2DM subjects more likely to have low proportion of CD36-ABCA+ macrophages compared to healthy donors (p=0.041) and it had negative correlation with glucose homeostasis and insulin resistance markers, including fasting blood glucose (FBG, r=-0.408, p=0.048), glycated hemoglobin (HbA1c, r=-0.380, p=0.049), triglyceride glucose index (r=-0,518, p=0.009), and high-sensitivity C-reactive protein (hs-CRP, r=-0.556, p=0.005). Moreover, it also had a negative correlation with atherogenic markers such as triglyceride (r=-0.417, p=0.043), triglyceride/HDL, and LDL/HDL, but had positive correlation with HDL (r=0.540, p=0.007). Most of T2DM subjects had high IL-1β/IL-10 ratio after ox-LDL and LPS stimulation (p=0.02 and p=0.05, respectively).CONCLUSION: Reduced proportion of CD36-ABCA1+ macrophages followed with high IL-1β/IL-10 can be a marker of CAD in T2DM.KEYWORDS: type 2 diabetes mellitus, coronary artery disease, macrophages, ABCA1, CD36
The Increase in CD14+CD16+ Monocytes is Correlated with Cardiovascular Disease Risk Marker in Type 2 Diabetes Hikmat, Ujang Saeful; Prijanti, Ani Retno; Wibowo, Heri; Sukmawati, Indriyanti Rafi; Tahapary, Dicky Levenus
The Indonesian Biomedical Journal Vol 16, No 1 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i1.2798

Abstract

BACKGROUND: Type 2 Diabetes (T2D) impairs the innate immune system including monocytes. Monocytes are divided into two subgroups depending on the expression of cluster of differentiation (CD)14 and CD16 receptors, namely CD14+CD16- and CD14+CD16+. CD14+CD16+ are proinflammatory monocytes and develop into M1 type macrophages, which contribute to foam cell production, a risk factor for cardiovascular disease (CVD). Therefore, it is important to determine the influence of T2D conditions on changes in monocyte subsets and whether these changes correlate with CVD risk markers.METHODS: Peripheral blood mononuclear cell (PBMC) was obtained from 10 T2D subjects and 10 healthy donors. Subsequently, PBMC was incubated for 24 hours with and without 10 mL lipopolysaccharide. Flow cytometry was used to evaluate CD14 and CD16 expression, while multiplex immunoassays were applied to measure interleukin (IL)-1b and IL-10 concentrations in supernatants.RESULTS: In T2D, the percentage of CD14+CD16+ monocytes increased (p=0.07), and an increase in CD14+CD16+ monocytes more than 6.8% was linked with CVD risk markers (r=10.146, p=0.002). Meanwhile, inflammatory mediators released by monocytes shown an increase in IL-1b (p=0.041) but not in IL-10 (p=0.082) in T2D subjects. Fasting blood glucose levels were also found to be substantially linked with an increase in CD14+CD16+ monocytes (r=0.530, p=0.016).CONCLUSION: T2D patients had a higher percentage of CD14+CD16+ monocytes and IL-1b levels than healthy donors. An increase in CD14+CD16+ monocytes above 6.8% associated with CVD risk markers in T2D patients.KEYWORDS: type 2 diabetes, monocytes, CD14, CD16, cardiovaskular disease risk marker
Kualitas Hidup Pasien Artritis Reumatoid dan Faktor-Faktor Yang Memengaruhi Hidayat, Rudy; Asicha, Nur; Tahapary, Dicky Levenus; Wibowo, Suryo Anggoro Kusumo
Majalah Kedokteran Indonesia Vol 73 No 2 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.2-2023-1032

Abstract

Introduction: Rheumatoid arthritis (RA) is a rheumatic disease that often results in functional disability and decreased health-related quality of life (HRQoL). This study aims to evaluate the HRQoL and related factors in patients with RA.Method: This study enrolled 152 patients from Rheumatology polyclinic at RSUPN Dr. Cipto Mangunkusumo Jakarta. Sosiodemographic, clinical, and laboratory data related to disease activity, functional status, psychological problems, and number of comorbidities were collected. Disease activity was assessed with cumulative Disease Activity Score-28 with erythrocyte sedimentation rate (DAS28 ESR) for the last 6 months. HRQoL was assessed using the Indonesian EuroQol five-dimensional questionnaire (EQ-5D) and EQ global health visual analogue scale (VAS). Univariate analysis, bivariate and multivariate analysis were employed to identify factors related to HRQoL.Result: Of the enrolled participants, 90.8% were female with a mean age of 49.41 ± 12.31 years. Majority of subjects had moderate disease activity and an independent functional status. Median duration of illness was 3 (0 – 34) years. The study also identified psychological disorders such as anxiety (11.2%) and depression (20.4%). The median EQ-5D index value was 0.84 (0.170 – 1.000), and the median EQ VAS was 70 (40 – 100). Functional disability, disease activity, and depression were independently associated with both the index EQ-5D score and EQ VAS, while anxiety and number of comorbidities were only independently associated with EQ VAS.Conclusion: Functional disability, disease activity, psychological disorders and number of comorbidities negatively impact the HRQoL of RA patients. Hence, evaluation of these factors should be considered in the standard of care for RA patients.
Manfaat Vaksinasi Influenza bagi Pasien Diabetes Melitus Kurniawan, Rudy; Tahapary, Dicky Levenus
Cermin Dunia Kedokteran Vol 51 No 3 (2024): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i3.1025

Abstract

People with diabetes mellitus have a dysregulated immune system and are more susceptible to infection, which poses a higher risk of severe influenza complications. Current evidence for influenza vaccine effectiveness in people with diabetes mellitus indicates a beneficial reduction of morbidity and mortality. In addition, serological studies show antibody levels elicited from influenza vaccination in diabetes patients show comparable results with healthy adults. Although more controlled clinical trials in diabetes mellitus patients with influenza are needed to reflect the effect of vaccination, current data indicate the need for routine influenza vaccination in diabetes mellitus patients, as recommended by guidelines. Efforts should be made to increase vaccination coverage in this risk group.
Tackling obesity in Indonesia: current problems and future directions Tahapary, Dicky Levenus
Medical Journal of Indonesia Vol. 33 No. 2 (2024): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.ed.247691

Abstract

[No abstract available]
Co-Authors ACHMAD FAUZI Achmad Fauzi Adelia Nova Prahasary Aida Lydia, Aida Ani Retno Prijanti Ani Retno Prijanti Arif Mansjoer Asicha, Nur Dekta Filantropi Esa Dyah Purnamasari Em Yunir Farissa Luthfia Heri Wibowo Hikmat, Ujang Saeful Idrus Alwi Luthfia, Farissa M. Rafi Marcellus Simadibrata Marcellus Simadibrata Muhadi Muhadi, Muhadi Nur Irawati Pratama, Derin Anugrah Pringgodigdo Nugroho Pringgodigdo Nugroho, Pringgodigdo Rona Kartika Rudy Hidayat Rudy Hidayat Rudy Kurniawan Sally Aman Nasution, Sally Aman Wibowo, Suryo Anggoro Kusumo Wismandari Wisnu Wismandari Wisnu