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Obesity and Endometrial Cancer: Mechanism and How to Deal with? Dewi Anggraeni, Tricia; Surya, Raymond; Pratama Kurniawan, Andrew
Cermin Dunia Kedokteran Vol 48, No 6 (2021): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Obesity is strongly associated with development of endometrial cancer more than any other cancer type. The relationship between obesity and endometrial cancer risk is combination of inflammation, insulin resistance, and increased bioavailability of estrogen. Obesity can increase risk to develop endometrial cancer as exogenous estrogen has impact for tumorigenesis. The best method to reduce the risk of endometrial cancer in obese women is through progesterone medication and lifestyle intervention.Obesitas erat kaitannya dengan terjadinya kanker endometrium lebih dari jenis kanker lainnya. Hubungan antara obesitas dan risiko kanker endometrium adalah kombinasi antara inflamasi, resistensi insulin, dan peningkatan bioavailabilitas estrogen. Obesitas dapat meningkatkan risiko terjadinya kanker endometrium karena estrogen eksogen berdampak pada tumorigenesis. Metode terbaik untuk mengurangi risiko kanker endometrium pada wanita yang obese adalah melalui pengobatan progesteron dan intervensi gaya hidup. Tricia

Upaya Menurunkan Angka Kematian Ibu akibat Perdarahan Pasca Persalinan di Indonesia melalui Inovasi Sistem Pelayanan Kesehatan Remifta Putra, Muhammad Alifian; Christopher Yo, Edward; Phowira, Jason; Dewi Anggraeni, Tricia
Cermin Dunia Kedokteran Vol 47, No 12 (2020): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Perdarahan pasca-persalinan (PPP) adalah komplikasi persalinan yang menyebabkan 35% seluruh kematian ibu di dunia. Meskipun PPP mulai jarang ditemui di negara maju, kondisi ini masih merupakan salah satu penyebab utama kematian ibu di negara berkembang seperti Indonesia. Hal ini antara lain akibat infastruktur kesehatan yang kurang optimal, sehingga terlambat mengidentifikasi faktor risiko PPP, merujuk, serta memberikan intervensi tepat waktu. Kajian pustaka ini mengamati adanya hubungan signifikan antara penurunan kematian ibu akibat PPP dan implementasi sistem peringatan dini obstetri, manajemen efektif, dan optimalisasi alur rujukan. Namun, karena tiap wilayah memiliki aspek sosioekonomis dan geografis yang berbeda, studi lanjutan diperlukan untuk menentukan pendekatan yang tepat bagi masing-masing wilayah di Indonesia.Postpartum hemorrhage (PPH) is a life-threatening condition that contributes to 35% of all maternal deaths worldwide. Although the risk of PPH has greatly declined in developed countries, it remains a leading cause of maternal mortality in developing countries like Indonesia. This issue could mainly be attributed to poor healthcare system and infrastructure leading to delay in identifying risk factors, referring mothers-at-risk to health centers, and appropriate intervention. We observed a notable relationship between decrease in maternal deaths due to PPH and the implementation of early warning system, effective PPH management, and optimization of referral system. These healthcare innovations showed promising potential in reducing the burden of PPH. However, since there is no single health policy that can be universally implemented, further research is needed to decide the best approach for each area depending on individual, socio-economic and geographic aspects.

Increasing the capacity of natural killer (NK) cells in fighting advance stage ovarian cancer: A cellular immunotherapy minireview Radiana Dhewayani Antarianto; Fransisca Dela Verna; Lady Feren Pangjaya; Sanya Khaerunnisa; Dinda Shezaria; Tricia Dewi Anggraeni
Current Research on Bioscences and Biotechnology Vol. 2 No. 1 (2020)
Publisher : Institut Teknologi Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.5614/crbb.2020.2.1/SPNZ3413

Global Cancer Statistics in 2018 estimated 300,000 new cases of ovarian cancer with 152,000 mortality rate each year. The Indonesian Society of Gynecologic Oncology reported 30% of gynecologic cancer is ovarian cancer, which has a 125, 000 mortality rate each year. Ovarian cancer data in Indonesia showed that 70% of patients were diagnosed with ascites or metastasis beyond the ovaries (stage III or IV). Ovarian cancer is an immunogenic disease with an immunotherapy intervention on the horizon. To assess the potency of stimulated NK cells as ovarian cancer cellular immunotherapy, literature search was collected from NCBI, ScienceDirect and Pubchem database. A total of 19 articles relevant to our search terms were included in this review. NK cells from ovarian cancer ascites exhibit low cytotoxic efficacy but can be restimulated using IL-2 or IL-15. An in vitro study that incubated NK cells with an IL-15 fusion protein enhanced the function of the ovarian cancer ascites’ NK cells or the healthy NK cells against the ovarian cancer ascites cells. Human IL-12-, IL-15- and IL-18-induced memory like (CIML) NK cells, has been proven to increase the elimination of xenograft human ovarian cancer cells over a long period of time in a mouse model. CIML NK cells also showed higher NK cell expansion and an enhanced function in the ovarian cancer ascites’ microenvironment, which was immunosuppressive. Phase I-II clinical trials on NK cell-based adoptive cellular therapies demonstrated limited clinical benefit. The major challenges are obtaining persistent NK cells with anticancer activity.

Invasive epithelial ovarian carcinoma (EOC) at a young age: role of fertility-sparing Puja Agung Antonius; Tricia Dewi Anggraeni
Jurnal Ilmu Kesehatan Indonesia Vol 2 No 2 (2021): Juni 2021
Publisher : Fakultas Kedokteran, Universitas Andalas

Objective: Improving knowledge to manage an invasive epithelial ovarian cancer at a young age who expect to preserve their reproductive function Method: a Case report Result : A 26 years old, nulliparity, Indonesian woman with chief complaint abdominal enlargement simultaneous with dyspnoea condition. Physical examination revealed an enlarged abdomen until processus xhypoideus with positive shifting dullness. Gynecology examination found normal uterine size, palpable cystic mass originated from adnexa until navel, mobile. CT whole abdomen showed a cystic solid mass in the pelvic area up to mid abdominal size 17,8 x 10,7 x 18,8 cm accompanied by lymphadenopathy in paraaortic and bilateral inguinal. Ascites and pleural fluid cytology examination results were both positive for malignant cells (metastatic adenocarcinoma). The patient was assessed as advanced staged ovarian cancer and procced for Interval Debulking Surgery (IDS) after 3 cycles of Neoadjuvant Chemotherapy (NACT). Postoperative histopathology examination result was high-grade clear cell ovarian carcinoma Conclusion: Fertility-sparing surgery for invasive epithelial ovarian carcinoma could be chosen for selective young age patients who fulfilled the criteria. Education and informed consent is a must regarding the risk of recurrence and prognosis. Keywords: Invasive EOC, fertility sparing, selection criteria, recurrence, prognosis

Socio-demographic Profiles of Cervical Cancer Patients at Cipto Mangunkusumo Hospital - 2009-2019 and Its Association with Cancer Stages at Diagnosis Fitriyadi Kusuma; Kemal Akbar Suryoadji; Michael Adrian; Tofan Widya Utami; Hariyono Winarto; Tricia Dewi Anggraeni; Kartiwa Hadi Nuryanto; Muhammad Haekal
Cermin Dunia Kedokteran Vol 49, No 5 (2022): Jantung dan Saraf
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i5.1846

Objective: To determine the socio-demographic profile of cervical cancer patients at Cipto Mangunkusumo Hospital in 2009-2019 based on educational level, parity, age, residence, and employment status and their relationship to cervical cancer stage at diagnosis. Methods: Comparative analytical study was conducted retrospectively based on medical records in Cipto Mangunkusumo Hospital. The selection was based on data completeness: cervical cancer stages, sociodemographic profiles consisting of education level, parity, age, Java or non-Java Island resident, and occupation. Multivariate analysis calculated the association between socio-demographic factors and cervical cancer stages. Data were analyzed using SPSS v.22.0 and Microsoft Excel. Results: This study included 4,584 patients with complete data. Only 19.3% patients were in the early stage, 63.3% had less than three parities, 82.8% of patients had formal primary school education or less, 80.9% patients were aged 18-65 years, 88.3% patients resided in Java Island, and 80.5% didn’t have the occupation. There was a significant association (p <0.05) between cervical cancer stage and educational level (aOR= 0.86; 95% CI= 0.78-0.94) and age (aOR= 1.46; 95% CI= 1.18-1.40). There is no significant association (p >0.05) between cervical cancer stage and parity, residence, and employment status. Conclusion: Low education and old age (> 65-year-old) were associated with the advanced stage of cervical cancer at diagnosis. Tujuan: Mengetahui profil sosiodemografi pasien kanker serviks di Rumah Sakit Cipto Mangunkusumo tahun 2009-2019 berdasarkan tingkat pendidikan, jumlah paritas, usia, status kependudukan, pekerjaan, serta hubungannya terhadap stadium kanker serviks saat diagnosis. Metode: Penelitian analitik komparatif retrospektif berdasarkan data rekam medis Rumah Sakit Cipto Mangunkusumo. Pemilihan sesuai kelengkapan data: stadium kanker serviks, profil status sosiodemografi yang terdiri atas tingkat pendidikan, paritas, usia, penduduk pulau Jawa atau non-Jawa, dan status pekerjaan. Hubungan antar variabel dianalisis multivariat untukmencari hubungan berbagai faktor sosiodemografi terhadap stadium kanker serviks. Analisis data menggunakan program SPSS versi 22.0 dan Microsoft Excel.Hasil: Terdapat 4.584 pasien kanker serviks yang memenuhi kriteria inklusi. Sebanyak 19,3% pasien dengan stadium awal. Selanjutnya 82,8% pasien memiliki pendidikan formal sekolah dasar atau kurang, 63,3% pasien memiliki jumlah paritas kurang dari tiga, 80,9% pasien berusia antara 18-65 tahun, 88,3% pasien berdomisili di pulau Jawa, dan 80,5% tidak bekerja. Didapatkan asosiasi bermakna (p<0,05) antara stadium kanker serviks dan tingkat pendidikan (aOR = 0,86; 95% CI= 0,78-0,94) dan usia (aOR= 1,46; 95% CI= 1,18-1,40). Tidak ditemukan asosiasi bermakna (p>0,05) antara stadium kanker serviks dengan paritas, domisilikependudukan, dan status pekerjaan. Simpulan: Tingkat pendidikan rendah dan usia lanjut (>65 tahun) berasosiasi dengan stadium lanjut kanker serviks saat diagnosis.

Obesity and Endometrial Cancer: Mechanism and How to Deal with? Tricia Dewi Anggraeni; Raymond Surya; Andrew Pratama Kurniawan
Cermin Dunia Kedokteran Vol 48, No 6 (2021): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i6.1437

Obesity is strongly associated with development of endometrial cancer more than any other cancer type. The relationship between obesity and endometrial cancer risk is combination of inflammation, insulin resistance, and increased bioavailability of estrogen. Obesity can increase risk to develop endometrial cancer as exogenous estrogen has impact for tumorigenesis. The best method to reduce the risk of endometrial cancer in obese women is through progesterone medication and lifestyle intervention.Obesitas erat kaitannya dengan terjadinya kanker endometrium lebih dari jenis kanker lainnya. Hubungan antara obesitas dan risiko kanker endometrium adalah kombinasi antara inflamasi, resistensi insulin, dan peningkatan bioavailabilitas estrogen. Obesitas dapat meningkatkan risiko terjadinya kanker endometrium karena estrogen eksogen berdampak pada tumorigenesis. Metode terbaik untuk mengurangi risiko kanker endometrium pada wanita yang obese adalah melalui pengobatan progesteron dan intervensi gaya hidup. Tricia

Upaya Menurunkan Angka Kematian Ibu akibat Perdarahan Pasca Persalinan di Indonesia melalui Inovasi Sistem Pelayanan Kesehatan Muhammad Alifian Remifta Putra; Edward Christopher Yo; Jason Phowira; Tricia Dewi Anggraeni
Cermin Dunia Kedokteran Vol 47, No 12 (2020): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i12.1250

Perdarahan pasca-persalinan (PPP) adalah komplikasi persalinan yang menyebabkan 35% seluruh kematian ibu di dunia. Meskipun PPP mulai jarang ditemui di negara maju, kondisi ini masih merupakan salah satu penyebab utama kematian ibu di negara berkembang seperti Indonesia. Hal ini antara lain akibat infastruktur kesehatan yang kurang optimal, sehingga terlambat mengidentifikasi faktor risiko PPP, merujuk, serta memberikan intervensi tepat waktu. Kajian pustaka ini mengamati adanya hubungan signifikan antara penurunan kematian ibu akibat PPP dan implementasi sistem peringatan dini obstetri, manajemen efektif, dan optimalisasi alur rujukan. Namun, karena tiap wilayah memiliki aspek sosioekonomis dan geografis yang berbeda, studi lanjutan diperlukan untuk menentukan pendekatan yang tepat bagi masing-masing wilayah di Indonesia.Postpartum hemorrhage (PPH) is a life-threatening condition that contributes to 35% of all maternal deaths worldwide. Although the risk of PPH has greatly declined in developed countries, it remains a leading cause of maternal mortality in developing countries like Indonesia. This issue could mainly be attributed to poor healthcare system and infrastructure leading to delay in identifying risk factors, referring mothers-at-risk to health centers, and appropriate intervention. We observed a notable relationship between decrease in maternal deaths due to PPH and the implementation of early warning system, effective PPH management, and optimization of referral system. These healthcare innovations showed promising potential in reducing the burden of PPH. However, since there is no single health policy that can be universally implemented, further research is needed to decide the best approach for each area depending on individual, socio-economic and geographic aspects.

Obesity and Endometrial Cancer: Mechanism and How to Deal with? Tricia Dewi Anggraeni; Raymond Surya; Andrew Pratama Kurniawan
Cermin Dunia Kedokteran Vol 48 No 6 (2021): Kardiologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i6.85

Obesity is strongly associated with development of endometrial cancer more than any other cancer type. The relationship between obesity and endometrial cancer risk is combination of inflammation, insulin resistance, and increased bioavailability of estrogen. Obesity can increase risk to develop endometrial cancer as exogenous estrogen has impact for tumorigenesis. The best method to reduce the risk of endometrial cancer in obese women is through progesterone medication and lifestyle intervention. Obesitas erat kaitannya dengan terjadinya kanker endometrium lebih dari jenis kanker lainnya. Hubungan antara obesitas dan risiko kanker endometrium adalah kombinasi antara inflamasi, resistensi insulin, dan peningkatan bioavailabilitas estrogen. Obesitas dapat meningkatkan risiko terjadinya kanker endometrium karena estrogen eksogen berdampak pada tumorigenesis. Metode terbaik untuk mengurangi risiko kanker endometrium pada wanita yang obese adalah melalui pengobatan progesteron dan intervensi gaya hidup.

Socio-demographic Profiles of Cervical Cancer Patients at Cipto Mangunkusumo Hospital - 2009-2019 and Its Association with Cancer Stages at Diagnosis Fitriyadi Kusuma; Kemal Akbar Suryoadji; Michael Adrian; Tofan Widya Utami; Hariyono Winarto; Tricia Dewi Anggraeni; Kartiwa Hadi Nuryanto; Muhammad Haekal
Cermin Dunia Kedokteran Vol 49 No 5 (2022): Neuro-Kardiovaskular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v49i5.227

Objective: To determine the socio-demographic profile of cervical cancer patients at Cipto Mangunkusumo Hospital in 2009-2019 based on educational level, parity, age, residence, and employment status and their relationship to cervical cancer stage at diagnosis. Methods: Comparative analytical study was conducted retrospectively based on medical records in Cipto Mangunkusumo Hospital. The selection was based on data completeness: cervical cancer stages, sociodemographic profiles consisting of education level, parity, age, Java or non-Java Island resident, and occupation. Multivariate analysis calculated the association between socio-demographic factors and cervical cancer stages. Data were analyzed using SPSS v.22.0 and Microsoft Excel. Results: This study included 4,584 patients with complete data. Only 19.3% patients were in the early stage, 63.3% had less than three parities, 82.8% of patients had formal primary school education or less, 80.9% patients were aged 18-65 years, 88.3% patients resided in Java Island, and 80.5% didn’t have the occupation. There was a significant association (p <0.05) between cervical cancer stage and educational level (aOR= 0.86; 95% CI= 0.78-0.94) and age (aOR= 1.46; 95% CI= 1.18-1.40). There is no significant association (p >0.05) between cervical cancer stage and parity, residence, and employment status. Conclusion: Low education and old age (> 65-year-old) were associated with the advanced stage of cervical cancer at diagnosis. Tujuan: Mengetahui profil sosiodemografi pasien kanker serviks di Rumah Sakit Cipto Mangunkusumo tahun 2009-2019 berdasarkan tingkat pendidikan, jumlah paritas, usia, status kependudukan, pekerjaan, serta hubungannya terhadap stadium kanker serviks saat diagnosis. Metode: Penelitian analitik komparatif retrospektif berdasarkan data rekam medis Rumah Sakit Cipto Mangunkusumo. Pemilihan sesuai kelengkapan data: stadium kanker serviks, profil status sosiodemografi yang terdiri atas tingkat pendidikan, paritas, usia, penduduk pulau Jawa atau non-Jawa, dan status pekerjaan. Hubungan antar variabel dianalisis multivariat untuk mencari hubungan berbagai faktor sosiodemografi terhadap stadium kanker serviks. Analisis data menggunakan program SPSS versi 22.0 dan Microsoft Excel. Hasil : Terdapat 4.584 pasien kanker serviks yang memenuhi kriteria inklusi. Sebanyak 19,3% pasien dengan stadium awal. Selanjutnya 82,8% pasien memiliki pendidikan formal sekolah dasar atau kurang, 63,3% pasien memiliki jumlah paritas kurang dari tiga, 80,9% pasien berusia antara 18-65 tahun, 88,3% pasien berdomisili di pulau Jawa, dan 80,5% tidak bekerja. Didapatkan asosiasi bermakna (p<0,05) antara stadium kanker serviks dan tingkat pendidikan (aOR = 0,86; 95% CI= 0,78-0,94) dan usia (aOR= 1,46; 95% CI= 1,18-1,40). Tidak ditemukan asosiasi bermakna (p>0,05) antara stadium kanker serviks dengan paritas, domisili kependudukan, dan status pekerjaan. Simpulan: Tingkat pendidikan rendah dan usia lanjut (>65 tahun) berasosiasi dengan stadium lanjut kanker serviks saat diagnosis.

Upaya Menurunkan Angka Kematian Ibu akibat Perdarahan Pasca-Persalinan di Indonesia melalui Inovasi Sistem Pelayanan Kesehatan Muhammad Alifian Remifta Putra; Edward Christopher Yo; Jason Phowira; Tricia Dewi Anggraeni
Cermin Dunia Kedokteran Vol. 47 No. 10 (2020): Dermatologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i10.556

Perdarahan pasca-persalinan (PPP) adalah komplikasi persalinan yang menyebabkan 35% seluruh kematian ibu di dunia. Meskipun PPP mulai jarang ditemui di negara maju, kondisi ini masih merupakan salah satu penyebab utama kematian ibu di negara berkembang seperti Indonesia. Hal ini antara lain akibat infastruktur kesehatan yang kurang optimal, sehingga terlambat mengidentifikasi faktor risiko PPP, merujuk, serta memberikan intervensi tepat waktu. Kajian pustaka ini mengamati adanya hubungan signifikan antara penurunan kematian ibu akibat PPP dan implementasi sistem peringatan dini obstetri, manajemen efektif, dan optimalisasi alur rujukan. Namun, karena tiap wilayah memiliki aspek sosioekonomis dan geografis yang berbeda, studi lanjutan diperlukan untuk menentukan pendekatan yang tepat bagi masing-masing wilayah di Indonesia. Postpartum hemorrhage (PPH) is a life-threatening condition that contributes to 35% of all maternal deaths worldwide. Although the risk of PPH has greatly declined in developed countries, it remains a leading cause of maternal mortality in developing countries like Indonesia. This issue could mainly be attributed to poor healthcare system and infrastructure leading to delay in identifying risk factors, referring mothers-at-risk to health centers, and appropriate intervention. We observed a notable relationship between decrease in maternal deaths due to PPH and the implementation of early warning system, effective PPH management, and optimization of referral system. These healthcare innovations showed promising potential in reducing the burden of PPH. However, since there is no single health policy that can be universally implemented, further research is needed to decide the best approach for each area depending on individual, socio-economic and geographic aspects.

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