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All Journal The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy

Marcellus Simadibrata

Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta

Author-ID : 5436042

Medicine & Pharmacology

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Articles

Nutritional Support in Critically Ill Patients Selfie Selfie; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 3 (2018): VOLUME 19, NUMBER 3, December 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Critically ill patient is at risk of malnutrition. The aim of nutritional support is to prevent malnutrition and its complication, and also fulfill macro- and micronutrient, reduce nitrogen deficit, and improve inflammaroty response. In critica patient with stable hemodynamic, enteral nutrition should be started early at 24-48 hours while patient not in ebb/resuscitation phase. Parenteral nutrition is not recommended in the first 24 hours of ICU care if enteral feeding is feasible. Parenteral nutrition is considered after 5-7 days, except poor enteral condition. Delay of parenteral nutrition for 7 days reduce risk of infection, increase recovery time, and reduce cost. On the first day, calorie should reach one third of actual need, increased to half to two third on second day, and full calorie on the third day. Total calorie need is 25-35 kcal/ideal bodyweight. Source of calorie is 60-70% carbohydrate and 30-40% lipid. Daily fluid need is 30-40 mL/kgBW/day or 1.0 – 1.5 mL/kcal calorie intake. Several important micronutrients to fulfill is sodium, potassium, calcium, phosphate, and magnesium. Three main consideration of nutritional support is route, type of formula, and when to start nutritional support.

Chronic Pancreatitis Indira Kemalasari; Murdani Abdullah; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 19, No 2 (2018): VOLUME 19, NUMBER 2, August 2018
Publisher : The Indonesian Society for Digestive Endoscopy

Chronic pancreatitis is a progressive inflammation in pancreas results in fibrosis and irreversible damage lead to loss of exocrine and endocrine function. Mortality and complication rate is high. Appropriate management of chronic pancreatitis begin from accurate diagnosis to adequate treatment. Diagnosis is still a challenge for clinician, mostly in early-stage disease. Several diagnostic modalities such computed tomography scan, magnetic resonance cholangiopancreaticography, endoscopic ultrasound, endoscopic retrograde cholangiopancreaticography, and direct-indirect pancreatic function test help diagnosis establishment. Endoscopic approach has an important role, both during diagnosis and treatment.

The Role of Vitamin D in Inflammatory Bowel Disease Pathogenesis and Management Randy Adiwinata; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 18, No 1 (2017): VOLUME 18, NUMBER 1, April 2017
Publisher : The Indonesian Society for Digestive Endoscopy

Vitamin D is widely recognized in maintaining bone metabolism and health. However, recent studies indicated that vitamin D also play important role in regulating immune system. Patients with inflammatory bowel disease (IBD) is commonly found to be vitamin D deficiency; whether it served as risk factor of IBD or as the consequence of disease activity are still debatable. Growing evidences showed that supplementation of vitamin D for IBD patients to achieve normal or optimal serum level may suppress the inflammatory process, reduce disease severity, maintaining remission status, and improving quality of life.

Survival of Pancreatic Cancer Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 2 (2019): VOLUME 20, NUMBER 2, August 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Use of Biologics in Inflammatory Bowel Disease: Combination and Sequential Therapy Putra Nur Hidayat; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 2 (2022): VOLUME 23, NUMBER 2, August 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Inflammatory bowel disease (IBD) in the form of ulcerative colitis (UC) and Crohn's disease (CD) has multifactorial etiology and multiple inflammatory pathways. Newer treatments with biologic agents are used as an adjunct to conventional therapy. Biological agents such as anti-TNF, anti-integrin, and anti-interleukin are believed to be able to overcome the inflammation that underlies the occurrence of IBD. The “step up” approach in IBD therapy uses conventional drugs with low potency but fewer side effects as the first line, followed by biologic agents as second line therapy. However, the result is often a delay in the management of severe complications of IBD. A “top down” approach is currently being used to successfully prevent severe complications of IBD by using biologic agents early. Biological agent therapy can be initiated in moderate to severe IBD either in combination or sequentially. But in the end, various parameters must be considered before starting the use of biologic agents such as drug effectiveness, safety profile, drug availability, price, and patient preferences.

Co-Authors Indira Kemalasari Murdani Abdullah Putra Nur Hidayat Randy Adiwinata Selfie Selfie

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