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All Journal The Indonesian Biomedical Journal Journal of Indonesia Vascular Access
Pertiwi, Putu Febry Krisna
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health

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Mechanical and bioprosthetic valves in young women: a systematic review and meta-analysis of cardiac, maternal, and fetal outcomes Harta, I Komang Adhi Parama; Pertiwi, Putu Febry Krisna; Yasa, Ketut Putu; Sudarma, I Wayan
Journal of Indonesia Vascular Access Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i2.70

Abstract

Valve replacement for the heart in young women, particularly those who are pregnant, is challenging. It requires finding the right balance between valve durability, managing anticoagulation, and ensuring positive reproductive outcomes. This systematic review and meta-analysis compared mechanical prosthetic (MP) and bioprosthetic valves (BP) across cardiac, maternal, and fetal outcomes. Nine studies were included following a comprehensive literature search. The analysis revealed MACE involving MP and BP were not significantly different (OR: 1.31, 95% CI: 0.82–2.09, p = 0.26). Thromboembolic events were significantly more frequent in the MP group (OR: 6.59, 95% CI: 3.41–12.74, p < 0.001), while structural valve deterioration (SVD) occurred more often in BP recipients (OR: 0.01, 95% CI: 0.00–0.70, p = 0.03). Maternal outcomes showed a higher risk of pregnancy loss in MP recipients (OR: 4.62, 95% CI: 1.87–11.40, p < 0.001). Preterm delivery was more common went down in the MP group, but it wasn't enough to warrant statistical analysis (OR: 2.20, 95% CI: 0.86–5.58, p = 0.10). For reoperation or redo surgery, MP had lower risk and showed superior results than BP (OR: 0.06, 95% CI: 0.01–0.32, p = 0.001). These findings highlight the complexities involved in choosing between valve types. Although MP valves last longer, they increase the likelihood of thromboembolic events and miscarriage. While improving results for both the mother and the unborn child, BP valves, are prone to structural deterioration, necessitating reoperation. Individualized treatment decisions that consider patient preferences, clinical context, and reproductive plans are essential to optimizing outcomes for young women requiring valve replacement.
Video-assisted thoracoscopic surgery vs. open thoracotomy in the management of empyema: A Meta-analytical perspective Sudarma, I Wayan; Yasa, Ketut Putu; Harta, I Komang Adhi Parama; Pertiwi, Putu Febry Krisna
Journal of Indonesia Vascular Access Vol. 4 No. 2 (2024): Available online : 1 December 2024
Publisher : Indonesian Vascular Access Association (IVAA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jinava.v4i2.72

Abstract

Background: Pleural empyema is a serious condition requiring surgical intervention in advanced stages. This systematic review and meta-analysis compared the outcomes of video-assisted thoracoscopic surgery (VATS) and open thoracotomy in the management of pleural empyema. Method: After performing a systematic search on electronic databases, 15 studies were included with a total of 1,795 patients. Result: The results demonstrated that VATS was associated with significantly shorter chest tube duration (MD: −2.68 days, 95% CI: −4.22 to −1.13, p < 0.001), reduced rates of prolonged air leak (OR: 0.44, 95% CI: 0.26 to 0.74, p = 0.001), and lower total complications (OR: 0.62, 95% CI: 0.44 to 0.87, p = 0.006). Mortality, reoperation rates, and recurrence rates were comparable between VATS and open thoracotomy, indicating similar efficacy for long-term disease resolution. In conclusion, this analysis highlights the advantages of VATS as a minimally invasive approach, particularly in reducing postoperative morbidity and complications. Conclusion: Open thoracotomy remains crucial for complex or advanced cases requiring extensive decortication. The findings underscore the importance of individualized surgical decision-making based on disease stage and patient characteristics.
Serum CD44 Variant 6 to CD44 Ratio and Vascular Endothelial Growth Factor Levels as Predictors of Metastasis in Luminal Subtype Breast Cancer Kendarini, Ni Putu Yenny; Manuaba, Ida Bagus Tjakra Wibawa; Sudarsa, I Wayan; Mahadewa, Tjokorda Gde Bagus; Dewi, Ni Nyoman Ayu; Prayuda, Prayuda; Pertiwi, Putu Febry Krisna
The Indonesian Biomedical Journal Vol 17, No 3 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i3.3586

Abstract

BACKGROUND: Metastasis is the leading cause of mortality in luminal subtype breast cancer. While cluster of differentiation (CD)44 has been widely studied, the prognostic relevance of its isoforms particularly the CD44v6/CD44s ratio remains unclear. This study evaluates CD44v6, CD44s, vascular endothelial growth factor (VEGF), and the CD44v6/CD44s ratio as potential prognostic biomarkers for metastasis in luminal breast cancer.METHODS: This case-control study included 38 luminal subtype breast cancer patients (18 with metastasis, 20 without metastasis). Serum levels of CD44v6, CD44s, VEGF, and the CD44v6/CD44s ratio were measured using Enzyme-Linked Immunosorbent Assay (ELISA). Statistical analyses included ROC analysis to determine optimal cut-off points, logistic regression to assess risk factors, and correlation analysis for biomarker relationships.RESULTS: A low CD44v6/CD44s ratio (<0.03) was identified as a significant independent factor for metastasis (adjusted OR 7.0, 95% CI: 1.2–40.6, p=0.03). While serum levels of CD44v6, CD44s, and VEGF were higher in the metastasis group, these individual markers showed a non-significant trend toward association with metastasis. A strong positive correlation was observed between CD44s and VEGF levels (r=0.7, p<0.01).CONCLUSION: The CD44v6/CD44s ratio showed a significant association with metastasis and may have potential as a prognostic marker in luminal breast cancer. Further studies with larger sample sizes are needed to confirm these findings.KEYWORDS: CD44v6, CD44s, VEGF, CD44v6/CD44s ratio, luminal breast cancer, metastasis
Co-Authors Harta, I Komang Adhi Parama I W. Sudarsa I Wayan Sudarma Kendarini, Ni Putu Yenny Ketut Putu Yasa Manuaba, Ida Bagus Tjakra Wibawa Ni Nyoman Ayu Dewi Prayuda, Prayuda Tjokorda Gde Bagus Mahadewa