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Journal : MEDICINUS

Di Balik Peradangan: Tinjauan tentang Peran Antinosiseptif Sel Imun dalam Modulasi Nyeri Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 6 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/zxrk2y26

Abstract

Immune cells have long been considered antagonists in pain physiology, as they have largely been viewed primarily through the lens of inflammation and nociceptive amplification. However, emerging research is reshaping this narrative. This article describes the evolving role of immune cells — not merely as proinflammatory molecules, but also as agents involved in pain modulation and suppression. Recent findings in neuroimmunology reveal a complex molecular dialogue between immune mediators and nociceptive pathways, particularly highlighting the contributions of regulatory T cells, macrophage subtypes, and glial cells in reducing nociceptive signals. Antinociceptive mechanisms mediated by cytokines, lipid-derived mediators, and immune-to neuronal communication are reviewed along with their translational potential in chronic pain therapy. By redefining the role of immune cells into central figures in the analgesic process, a paradigm shift is emerging, which requires an integrative approach in pain research and therapy.
Uji Klinik Terdesentralisasi: Mendefinisikan Ulang Partisipasi, Kuasa, dan Presisi dalam Riset Kesehatan Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 6 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/trzykz54

Abstract

Decentralized clinical trials (DCTs) have emerged as a transformative force in biomedical research, breaking down traditional boundaries and reshaping how evidence is generated, validated, and applied. By leveraging digital health technologies, real-world data, and remote engagement infrastructures, DCTs have the potential to democratize clinical research by improving inclusivity and accessibility. However, these opportunities come with challenges related to regulatory governance, technological ethics, and socio-political representation. This brief article explores both the conceptual and empirical foundations of DCTs, drawing from recent studies, international policy documents (such as white papers), regulatory initiatives, and global practice surveys. It examines the epistemological, operational, and normative shifts introduced by DCTs and proposes a framework for understanding their impact on three core dimensions of clinical science: participation, power, and precision. Ultimately, this article argues that DCTs are not merely a digital enhancement, but rather a fundamental reconfiguration of how health knowledge is generated and governed.
Epigenom yang Berkembang: Fungsi dan Aplikasinya Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 7 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/1cyz2p11

Abstract

Epigenome is a set of reversible modifications that synergistically regulate gene expression without altering the DNA sequence. The epigenome serves as a functional bridge between the genome and the environment, enabling precise spatiotemporal regulation of gene expression, which is crucial for cellular identity and development of organisms. Unlike the static genome, the epigenome is dynamic and responsive to endogenous and exogenous signals, including developmental, metabolic, environmental stress, and pathological conditions. This paper comprehensively reviews the fundamental mechanisms of epigenetic dynamics, its role in phenotype formation, and its implications in disease etiology and therapeutic innovation. By integrating cutting-edge findings from developmental biology, oncology, neurobiology, and regenerative medicine, the epigenome can be understood as a multidimensional lens for interpreting biological memory, developmental plasticity, and potential molecular engineering.
The Effect of Phaleria macrocarpa Bioactive Fraction (Proliverenol) Supplementation on Liver Damage in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD) Irsan Hasan; Saut Horas Hatoguan Nababan; Raymond R. Tjandrawinata; Danang Agung Yunaidi; Liana W. Susanto
MEDICINUS Vol. 38 No. 7 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/a4ba3z37

Abstract

Liver is considered one of the most vital organs, acting as the center of metabolism of nutrients and excretion of waste products. Non-alcoholic fatty liver disease (NAFLD) is one of the main causes of chronic liver disease. The management of NAFLD continues to evolve, and clinicians are currently faced with a variety of alternative options, both nonpharmacotherapeutic and pharmacotherapy, to avoid more severe liver disease. Phaleria macrocarpa (Scheff.) Boerl., namely, mahkota dewa in Indonesia, has been used empirically to treat cancer, allergy, and diabetes mellitus. Proliverenolis a proprietary bioactive fraction derived from the dried fruit of Phaleria macrocarpa (Scheff.) Boerl. Proliverenol was reported to have hepatoprotective, anti-inflammatory, antioxidant, and antifibrotic effects. The study found that Proliverenol bioactive fraction, at a dosage of 1000 mg twice daily for at least 4 weeks of treatment, is effective in improving liver damage with a good safety profile.
Tinjauan Terpadu terhadap Terapi Presisi dan Standardized Herbal Drug untuk Non-Alcoholic Fatty Liver Disease (NAFLD): Kemajuan Molekuler, BuktiKlinis, serta Implikasi Integratif Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 7 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/mh4ry926

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a progressive hepatic disorder that has become a central component of the global metabolic syndrome spectrum. Its complex pathogenesis involves insulin resistance, chronic inflammation,oxidative stress, and activation of fibrogenic pathways. Along with the deepening understanding of molecular mechanisms,precision therapies targeting farnesoid X receptor (FXR) agonists, peroxisome proliferator-activated receptor (PPAR) modulators, incretin mimetics, and RNA-based technologies are being developed, although challenges remain concerningside effects and accessibility. In this context, Veprolin containing Proliverenol, a bioactive fraction of Phaleria macrocarpa, offers potential as an adjuvant standardized herbal drug with anti-inflammatory, antifibrotic, and reparative effects, as demonstrated in preclinical studies. This review highlights the importance of integrative, precision-oriented, and sustainable multimodal therapeutic strategies.
Pendekatan Integratif dalam Manajemen Dengue Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 8 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/699q0n64

Abstract

Dengue, as one of the most challenging tropical diseases of the 21st century, continues to present significant clinical and epidemiological complexities in developing countries, including Indonesia. With the increasing incidence of global dengue infections and the limited availability of definitive therapeutic options, clinical management is shifting toward optimizing supportive therapy and exploring adjuvant strategies to improve key clinical parameters such as hemodynamic and platelet count. By emphasizing the role of two interventions, Gelafusal (gelatin solutions) as a colloid fluid for resuscitation and Psidii (Psidium guajava folium extracts) as a platelet production-stimulating agent, through the lens of bioethics, pharmacodynamics, and evidence-based clinical strategies, this review offers a critical reflection on the opportunities and limitations of applying multimodal interventions in dengue management.
Inovasi dan Praktik Terbaik dalam Model Tikus Hasil Rekayasa Genetik untuk Penelitian Praklinis dan Translasional Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 8 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/26jxqx92

Abstract

Genetically engineered mouse models (GEMMs) have undergone significant evolution since their initial development in the late 1980s. Over the past decade, advancements in genome editing technologies such as clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9, base editing, and prime editing, have sparked a new wave of innovation in the design and application of GEMMs. This article explores the historical development of GEMMs, recent technical advancements beyond CRISPR, their broad-spectrum applications across diseases, including autoimmune and cardiovascular, integration of multiomics approaches, and the role of GEMMs in pharmacokinetic and pharmacodynamicstudies. It also addresses aspects of colony management, experimental animal ethics, international regulations, convergence with artificial intelligence, and case studies of successful clinical translation based on studies using GEMMs. By synthesizing the latest literature from various international databases, this article provides a strategic guide for researchers to optimize the potential of GEMMs in improving the accuracy and translational relevance of innovative therapy development.
Farmakogenomik dalam Pengobatan Presisi: Tinjauan dengan Studi Kasus Clopidogrel dan Tren Masa Depan Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 9 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/fqx9vg55

Abstract

Pharmacogenomics has emerged as a cornerstone in the development of precision medicine, aiming to tailor drug therapy based on an individual’s genetic profile. By identifying genetic variations that influence drug metabolism, efficacy,and safety, pharmacogenomics paves the way for improved therapeutic outcomes reduced adverse drug reactions. One of the most significant examples in clinical practice is clopidogrel, an antiplatelet agent whose biopharmacologicalactivation depends on the CYP2C19 enzyme. Genetic variations in CYP2C19 significantly affect the clinical effectiveness of clopidogrel and the risk of major cardiovascular events. This article outlines recent developments in the implementationof pharmacogenomics, focusing on the clopidogrel case study, while also exploring other key gene–drug interactions such as codeine/CYP2D6, warfarin/VKORC1, and statin/SLCO1B1. The review also maps future trends in pharmacogenomics,including multiomic integration, preemptive genotyping, AI-based predictive modeling, and the potential for gene-editing interventions such as clustered regularly interspaced short palindromic repeats (CRISPR). Despite significant progress,implementation challenges remain, ranging from cost and healthcare infrastructure to ethical and regulatory dilemmas. This review aims to provide both a conceptual and practical foundation for the development of truly personalized pharmacotherapy in the future.
Dasar Neurobiologis Akuisisi Bahasa Dini: Mengapa Anak masih Mengungguli Kecerdasan Buatan Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 9 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/qk5jw768

Abstract

Despite remarkable advances in artificial intelligence that have produced large language models (LLMs) capable of mimicking human linguistic behavior with high levels of sophistication, these systems still fall significantly short of the abilities of children in acquiring language rapidly, flexibly, and contextually. This article presents a systematic review from the perspective of cognitive and developmental neuroscience to address the question of why children remain superior in language learning compared to artificial intelligence systems. By examining mechanisms such as neuroplasticity, the involvement of social affective circuits, reward prediction systems, and multimodal sensorimotor functions in child language development, the article argues that human language acquisition is a phenomenon deeply embedded in the body, social relationships, and biological drives-dimensions that artificial systems inherently lack. The implications of this review extend to clinical interventions, education, and the development of AI systems that more closely approximate human neurocognitive architecture.
Menimbang Strategi Penatalaksanaan Deep Vein Thrombosis pada Pasien Strok Hemoragik Raymond R. Tjandrawinata
MEDICINUS Vol. 38 No. 10 (2025): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/nca87c96

Abstract

Hemorrhagic stroke is an acute condition with high morbidity and mortality rates, and is frequently accompanied by complications such as deep vein thrombosis (DVT). The main dilemma in managing DVT in this condition is a therapeutic paradox, where anticoagulants use is effective in preventing pulmonary embolism, but carries the risk of worsening intracranial bleeding. International guidelines recommend mechanical prophylaxis, such as intermittent pneumatic compression (IPC), and cautious use of low-dose anticoagulants in stable hematomas, although clinical evidence remains limited. Biological alternatives, such as DLBS1033, derived from Lumbricus rubellus, have shown potential safety and efficacy in case reports from Indonesia. Ethical perspectives, health policy, as well as pharmacological innovations andartificial intelligence, are essential to develop adaptive, equitable, and evidence-based strategies in the management of DVT following hemorrhagic stroke.
Co-Authors Achmad K. Harzif Agung Endro Nugroho Agung Endro Nugroho Andon Hestiantoro Andri Prasetiyo Anindini Winda Amalia Anindyajati Anindyajati Anita Artarini Armini Syamsidi ARTARINI, ANITA B. Atawolo, Andreas Babu, Murali Mohan Budi Wiweko Caroline G. Puspita CATUR RIANI Danang Agung Yunaidi Dayana, Hepy Debbie S. Retnoningrum Debbie S. Retroningrum DEBBIE SOEFIE RETNONINGRUM Dewi Riskha Nurmalasari Diana Nur Afifah Esti Mumpuni Esti Mumpuni Esti Mumpuni, Esti Gayatri, Anggi Gita Pratama Hapsari, Riani Hartati Tuna, Hartati Heliany, Ina Henry Soelistyo Budi Henry Soelistyo Budi, Henry Soelistyo Herbert Situmorang Herbert Situmorang Huda Shalahudin Darusman Indriawati, Iin Irsan Hasan Ismaya, Wangsa T. Kaka Renaldi Kanadi Sumapradja Krisnayanti, Ni Putu Eka Kristiana, Hery Kristiana, Hery Laurentia Stephani Liana W. Susanto Lilik Sulastri Luh Putu Nurshanti, Ni Maggy T. Suhartono Maggy T. Suhartono Maggy Thenawidjaja Suhartono Marcellus Simadibrata Martha Wijaya, Harry Melva Louisa Murdani Abdullah Nafrialdi Nafrialdi Nailufar, Florensia Nailufar, Florensia Novia Tri Astuti Novia Tri Astuti Novitasari, Putri Rachma Permanasari, Silmi Citra Rachman, Andika Raden Muharam Natadisastra Retroningrum, Debbie S. Santi Tan Saut Horas Hatoguan Nababan Setiabudy, Rahajuningsih D Shirly Kumala SILMI MARIYA Simatupang, Stefeny Theresia Sinaga, Wenny S.L. Soelistyo Budi, Henry Susanto, Liana W Suwijiyo Pramono Suwijiyo Pramono Tan, Santi Viedya Novalinda Said Wangsa T. Ismaya Wangsa Tirta Ismaya Widjaja, Nadia Winoto, Imelda L Winoto, Imelda L Yanti Lim Zaelani, Bella Fatima Dora