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Bioscientia Medicina : Journal of Biomedicine and Translational Research

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Published by Universitas Sriwijaya

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Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

BioScientia Medicina is an open access international scholarly journal in the field of biomedicine and translational research aimed to publish a high-quality scientific paper including original research papers, reviews, short communication, and technical notes. This journal welcomes the submission of articles that offering a sensible transfer of basic research to applied clinical medicine. BioScientia Medicina covers the latest developments in various fields of biomedicine with special attention to medical sciences, Traditional Herb, genetics, immunology, environmental health, toxicology, bioinformatics and biotechnology as well as multidisciplinary studies. The views of experts on current advances in nanotechnology and molecular/cell biology will be also considered for publication as long as they have a direct clinical impact on human health.

Arjuna Subject : Kedokteran - Anatomi

Articles 1,209 Documents

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Modulation of TGF-β/Smad and Nrf2 Signaling Pathways by Thymoquinone in the Attenuation of Renal Fibrosis: A Systematic Review and Meta-Analysis of Pre-clinical Models Chairil Makky; Ian Effendi; Zulkhair Ali; Novadian; Suprapti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1491

Background: Renal fibrosis is the irreversible, final common pathway for all progressive forms of chronic kidney disease (CKD), leading to end-stage renal disease. Its pathogenesis is characterized by the over-activation of pro-fibrotic signaling, chiefly the Transforming Growth Factor-beta (TGF-β)/Smad pathway, and the failure of endogenous cytoprotective mechanisms like the nuclear factor erythroid 2-related factor 2 (Nrf2) antioxidant response. Thymoquinone (TQ), the primary bioactive constituent of Nigella sativa, is a pleiotropic compound with known anti-inflammatory and antioxidant properties. This study was designed to systematically quantify its mechanistic efficacy in modulating the core Nrf2 and TGF-β pathways in established pre-clinical models of renal fibrosis and injury. Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines. We performed a comprehensive search of major databases (including PubMed and Scopus) for pre-clinical in vivo studies published between 2014 and 2025 that investigated TQ monotherapy or TQ-dominant combination therapy in rodent models of renal injury. The eight studies that met the inclusion criteria utilized diverse models: Unilateral Ureteral Obstruction (UUO), cisplatin-induced nephrotoxicity, gentamicin-induced nephrotoxicity, 5-fluorouracil (5-FU)-induced acute kidney injury (AKI), lipopolysaccharide (LPS)-induced inflammation, carfilzomib (CFZ)-induced renal impairment, and ischemia-reperfusion (IRI). Primary outcomes were the expression of renal Nrf2 and TGF-β1. Secondary outcomes included markers of fibrosis (collagen deposition, histology scores), renal function (BUN, creatinine), oxidative stress (MDA, SOD, GSH, CAT), and inflammation (TNF-α, NF-κB, IL-6, IL-1β). Data were pooled using a random-effects model, and primary analyses were stratified by injury model subgroup. Results: Thymoquinone treatment resulted in a profound and significant upregulation of the protective Nrf2 pathway (SMD: 2.38; 95% CI [1.05, 3.71]; p < 0.001; 3 studies) and its downstream target Heme Oxygenase-1 (HO-1). Concurrently, TQ treatment markedly suppressed the primary pro-fibrotic driver, TGF-β1 (SMD: -2.09; 95% CI [-2.99, -1.19]; p < 0.001; 2 studies). This pivotal dual modulation translated into significant functional and structural improvements. TQ robustly attenuated renal fibrosis scores (SMD: -1.89; 95% CI [-2.55, -1.23]; p < 0.001; 2 studies). Stratified subgroup analysis showed TQ significantly improved renal function in both chemotoxic AKI models (BUN SMD: -2.31; 95% CI [-3.22, -1.40]) and chronic obstructive/fibrosis models (BUN SMD: -1.17; 95% CI [-1.75, -0.59]). This functional protection was underpinned by potent, broad-spectrum reversal of oxidative stress and inflammation across all subgroups. Conclusion: Thymoquinone consistently ameliorates renal injury and fibrosis across a wide spectrum of pre-clinical models. Its mechanism of action is multifaceted, critically involving the dual modulation of opposing pro-fibrotic and protective pathways: it suppresses the TGF-β1 cascade while simultaneously activating and restoring the Nrf2 antioxidant response. This body of evidence strongly supports Thymoquinone as a high-potential candidate for translational research and development as a novel, network-targeting therapy for human renal fibrosis.

Beyond Phosphate Binding: A Systematic Review and Meta-Analysis on the Efficacy and Safety of the Novel Paracellular Phosphate Inhibitor, Tenapanor, for Hyperphosphatemia in Dialysis Patients Eva Julita; Ian Effendi; Zulkhair Ali; Novadian; Suprapti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1492

Background: Hyperphosphatemia is a critical driver of cardiovascular morbidity and mortality in patients with chronic kidney disease (CKD) undergoing dialysis. Current management, reliant on phosphate binders, is hampered by high pill burden and poor adherence. Tenapanor, a first-in-class, minimally-absorbed sodium/hydrogen exchanger 3 (NHE3) inhibitor, reduces paracellular phosphate absorption. We performed a systematic review and meta-analysis of all available Phase 3 trials to quantify its efficacy and safety. Methods: We searched PubMed, Embase, and Cochrane CENTRAL through October 2025 for Phase 3 clinical trials evaluating tenapanor for hyperphosphatemia in dialysis patients. Data were extracted from 6 eligible studies (N=1573). We conducted separate random-effects meta-analyses for different study designs: 1) parallel-group monotherapy vs. placebo, 2) withdrawal-design monotherapy vs. placebo, 3) parallel-group add-on therapy vs. placebo, and 4) safety (diarrhea incidence) vs. placebo. Efficacy was measured by Mean Difference (MD) in serum phosphate change; safety by Risk Ratio (RR). Results: Tenapanor demonstrated significant efficacy across all study designs. In parallel-group monotherapy (1 study, N=167), tenapanor was superior to placebo (MD: -1.89 mg/dL; 95% CI: -2.36 to -1.42). In withdrawal-design studies (2 RCTs, N=373), tenapanor maintained serum phosphate levels significantly better than placebo (Pooled MD: -0.75 mg/dL; 95% CI: -1.05 to -0.45; I2=0%). As an add-on therapy (1 RCT, N=235), tenapanor provided additional phosphate reduction versus binders alone (MD: -0.65 mg/dL; 95% CI: -0.96 to -0.35). Tenapanor significantly increased the risk of diarrhea versus placebo (3 RCTs, N=521; Pooled RR: 4.10; 95% CI: 2.50 to 6.72; I2=30%), which was the primary adverse event leading to discontinuation. Conclusion: Tenapanor represents a new mechanistic paradigm for hyperphosphatemia management. It is a highly effective phosphate-lowering agent, both as monotherapy and add-on therapy, but is associated with a significant, mechanism-based risk of gastrointestinal side effects.

Complete Clinical and Trichoscopic Remission of Refractory Patch Alopecia Areata with a Multi-Modal Microneedling and Vitamin D3 Protocol: A Case Report Stephanie Lukita; Ferra Olivia Mawu; Thigita Aga Pandaleke
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1493

Background: Refractory patch alopecia areata (AA) presents a significant therapeutic challenge, as many patients fail first-line treatments. This gap necessitates the exploration of novel, mechanistically-targeted therapeutic strategies. Case presentation: We present the case of a 44-year-old female with a 2.5 × 3.0 cm patch of AA, refractory to a 3-month compliant trial of topical 0.25% desoximetasone and 5% minoxidil. Baseline diagnostics included histopathology (peribulbar lymphocytic infiltrate), quantitative trichoscopy (yellow dots, black dots, exclamation mark hairs), and laboratory workup, which revealed a serum 25-hydroxyvitamin D [25(OH)D] insufficiency (18.2 ng/mL). A multi-modal protocol was initiated: (1) systemic 5,000 IU/day oral cholecalciferol, (2) 10 sessions of 1.5 mm microneedling at two-week intervals, and (3) immediate post-procedure application of topical 100,000 IU cholecalciferol. Significant regrowth of pigmented terminal hairs was observed by week 12. After 20 weeks (10 sessions), complete clinical regrowth was achieved. Final quantitative trichoscopy confirmed the full resolution of all pathological markers, with a healthy density of terminal hairs. The patient’s systemic 25(OH)D level was corrected to 41.5 ng/mL. The treatment was well-tolerated. Conclusion: This case report documents a complete remission associated with a multi-modal protocol. The contribution of the systemic vitamin D repletion is a major, unresolvable confounder, making attribution impossible. However, this hypothesis-generating case suggests a combined (systemic, physical, and topical) approach may represent a potential rescue strategy for refractory patch AA, warranting further controlled investigation.

Beyond the Usual Suspects: Phialophora verrucosa Chromoblastomycosis in a Swimming Pool Attendant and Gardener Andrew Wicaksono; Ni Luh Putu Ratih Vibriyanti Karna; Mario Korwa; Nandya Dwizella; Herman Saputra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1422

Background: Chromoblastomycosis (CBM) is a chronic, debilitating subcutaneous mycosis caused by traumatic inoculation of dematiaceous fungi. As a Neglected Tropical Disease, it poses significant diagnostic and therapeutic challenges, particularly in the endemic tropical and subtropical regions where it is most prevalent. While Fonsecaea pedrosoi is the most common etiologic agent, infections by other species are crucial to document for accurate epidemiological surveillance. Case presentation: A 26-year-old immunocompetent male presented with a four-year history of a slowly progressive, verrucous plaque on his right hand, initiated by minor trauma. His history was notable for regular gardening without protective gear. A comprehensive diagnostic workup was performed. Dermoscopy revealed features characteristic of CBM, including reddish-black dots and yellowish-orange areas. While direct microscopy of skin scrapings was negative, histopathology of a skin biopsy confirmed a suppurative granulomatous reaction with pathognomonic muriform cells. Fungal culture on Sabouraud's dextrose agar definitively identified the causative agent as Phialophora verrucosa. The patient showed marked clinical improvement after three months of treatment with oral itraconazole (200 mg/day). Conclusion: This case highlights the successful diagnosis of a rare CBM pathogen in Indonesia through a systematic, multimodal approach. It reinforces the need for a high index of suspicion for this mycosis in patients from endemic areas with chronic verrucous lesions and a history of cutaneous trauma. The essential role of mycology culture for definitive species identification is underscored, a critical step for guiding therapy and informing public health strategies.

Catamenial Pneumothorax in a Patient with Adenomyosis: A Case Report on a Successful Multidisciplinary Approach with Pleurodesis and Hormonal Therapy Vanny Syafitri; Suyastri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1423

Background: Catamenial pneumothorax, a rare manifestation of thoracic endometriosis syndrome (TES), presents a significant diagnostic and therapeutic challenge. It is characterized by recurrent spontaneous pneumothorax occurring in temporal relation to menstruation in women of reproductive age. The underlying pathophysiology is complex, often involving the ectopic presence of endometrial tissue within the thoracic cavity. Coexisting pelvic pathologies, such as adenomyosis, may be associated, further complicating the clinical picture. Case presentation: We present the case of a 38-year-old woman with a four-month history of recurrent, right-sided pneumothorax, with symptoms consistently commencing 24 to 48 hours prior to the onset of her menstrual cycle. Initial investigations, including high-resolution computed tomography of the thorax performed between menstrual cycles and microbiological analysis for tuberculosis, were unremarkable. The diagnosis of catamenial pneumothorax was established based on the distinct cyclical pattern of her symptoms. A subsequent gynecological evaluation, prompted by a history of secondary dysmenorrhea and menorrhagia, revealed uterine adenomyosis via transvaginal ultrasonography. The patient was managed through a collaborative, multidisciplinary approach involving pulmonology, thoracic surgery, and gynecology. Treatment consisted of chemical pleurodesis with doxycycline, administered via a chest tube, followed by continuous hormonal suppression therapy with oral progestin (2 mg/day). Conclusion: This case highlights the critical importance of maintaining a high index of suspicion for catamenial pneumothorax in women of reproductive age presenting with recurrent pneumothorax. A successful outcome was achieved through a coordinated, multidisciplinary strategy combining definitive pleural symphysis via pleurodesis with systemic hormonal therapy to suppress the underlying endometriotic process. This dual approach effectively prevented pneumothorax recurrence over a 12-month follow-up period, underscoring its efficacy in managing this complex condition.

Diagnostic Performance of Imaging Modalities in Persistent or Recurrent Hyperparathyroidism: A Network Meta-Analysis of 18F-Fluorocholine PET/CT, 4D-CT, and Scintigraphy Hendry Johan Renaldy Tandra; Endah Indriani; Hendra Budiawan; Basuki Hidayat
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1424

Background: The surgical management of persistent or recurrent primary hyperparathyroidism (PHPT) is critically dependent on accurate preoperative localization of ectopic or residual hyperfunctioning glands within a scarred anatomical field. While 18F-Fluorocholine Positron Emission Tomography/Computed Tomography (18F-FCH PET/CT), four-dimensional computed tomography (4D-CT), and 99mTc-Sestamibi scintigraphy are employed, a definitive evidence-based hierarchy to guide their use is absent. This study aimed to establish this hierarchy by comparing their diagnostic performance through a network meta-analysis. Methods: A systematic search of PubMed, Embase, and Scopus was conducted for comparative studies published between January 2015 and August 2025 evaluating these modalities in persistent/recurrent PHPT. A Bayesian bivariate network meta-analysis was performed to calculate pooled sensitivities and specificities on both a per-patient and per-lesion basis. Modalities were ranked using Surface Under the Cumulative Ranking (SUCRA) scores. Methodological quality, inconsistency, and heterogeneity were formally assessed. Results: Seven studies involving 687 patients were included. On a per-patient analysis, 18F-FCH PET/CT demonstrated the highest sensitivity at 94.1% (95% Credible Interval [CrI]: 89.8%–97.5%), significantly outperforming 4D-CT (82.5%; 95% CrI: 75.1%–88.9%) and scintigraphy with SPECT/CT (60.3%; 95% CrI: 51.2%–69.1%). Specificities were uniformly high. Per-lesion analysis confirmed this hierarchy. SUCRA rankings identified 18F-FCH PET/CT as the superior modality for both per-patient (98.7%) and per-lesion (99.1%) detection. No significant network inconsistency was detected. Conclusion: 18F-FCH PET/CT exhibits superior diagnostic accuracy for localizing culprit parathyroid glands in persistent or recurrent PHPT. Its performance, grounded in robust metabolic targeting that overcomes the challenges of a reoperative field, supports its positioning as the primary imaging modality in this setting. These findings advocate for a revision of current diagnostic algorithms to enhance surgical planning and improve patient outcomes.

Efficacy, Safety, and Metabolic Effects of Low-Molecular-Weight Heparin versus Unfractionated Heparin in Chronic Hemodialysis: A Systematic Review and Meta-Analysis of Clinical Studies Evelin Veronike; Harnavi Harun; Drajad Priyono; Deka Viotra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1494

Background: The optimal anticoagulation for chronic hemodialysis (HD) remains debated. Unfractionated heparin (UFH) is the historical standard but carries risks of metabolic complications and requires intensive monitoring. Low-Molecular-Weight Heparin (LMWH) offers pharmacological advantages, but concerns over bleeding risk in end-stage renal disease (ESRD) have limited its use. This study aimed to provide a holistic comparison by synthesizing recent evidence on the efficacy, safety, and, uniquely, the key metabolic consequences of LMWH versus UFH. Methods: This systematic review followed PRISMA 2020 guidelines. We searched PubMed, EMBASE, and CENTRAL from January 2014 to March 2025 for clinical studies comparing LMWH and UFH in chronic HD patients. We included 6 studies (3 prospective trials, 3 retrospective cohorts) totaling 7,890 patients. The primary efficacy outcome was circuit thrombosis; the primary safety outcome was major bleeding. Secondary outcomes focused on key metabolic markers (pre-dialysis potassium, lipid profile). Data from prospective trials and observational studies were analyzed separately using subgroup analysis and tested for interaction. Metabolic data were pooled using a random-effects model. Results: The analysis of key metabolic outcomes, derived from homogenous prospective trials (I2=0%), was the most robust finding. LMWH use was associated with a clinically significant reduction in pre-dialysis serum potassium (Mean Difference [MD]: -0.30 mEq/L; 95% CI: -0.50 to -0.10) and a superior atherogenic profile, including lower triglycerides (MD: -20.10 mg/dL) and higher HDL (MD: +4.50 mg/dL). For safety, no difference in major bleeding was found, a finding that was consistent across prospective trials (OR: 0.78; 95% CI: 0.33-1.85) and large retrospective cohorts (OR: 0.87; 95% CI: 0.69-1.09), with no subgroup interaction (p=0.75). Efficacy for preventing circuit thrombosis was also similar. Conclusion: This meta-analysis provides strong, high-quality evidence that LMWH confers significant and clinically relevant metabolic advantages over UFH, particularly in mitigating hyperkalemia and atherogenic dyslipidemia. Furthermore, our stratified analysis provides high confidence from real-world data that LMWH, when dosed appropriately, is as safe and effective as UFH.

Metastatic Medullary Thyroid Carcinoma Mimicking a Primary Soft Tissue Sarcoma of the Shoulder: A Case Report Putri, Syifa Azizah; Kiki Akhmad Rizki; Rupita Endangena Sitanggang
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1495

Background: Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignancy accounting for 1-5% of thyroid cancers. While often presenting with cervical lymphadenopathy, distant metastasis to bone and soft tissue mimicking a primary sarcoma is exceptionally rare. This report details a case of MTC where the primary diagnostic challenge was a massive, destructive shoulder mass. Case presentation: A 58-year-old woman presented with a disabling, 20 cm mass in her left shoulder, progressively enlarging over two years. The patient also noted a 30-year history of a stable, asymptomatic neck lump. Magnetic Resonance Imaging (MRI) revealed a large, hypervascular, destructive mass obliterating the scapula and invading surrounding musculature, with a radiological differential diagnosis of a primary soft tissue sarcoma. Laboratory investigation, however, revealed a massively elevated serum calcitonin (>2000 pg/mL) and carcinoembryonic antigen (CEA) (180 ng/mL). A CT-guided core biopsy of the shoulder mass, initially suspected to be a sarcoma, was negative for all sarcoma markers. Instead, it was strongly positive for neuroendocrine (Synaptophysin, Chromogranin A) and thyroid-specific (TTF-1, PAX-8) markers, as well as definitive MTC markers (Calcitonin, CEA). This confirmed the diagnosis of metastatic MTC. Staging was completed as pT3a pN1b M1. The patient underwent total thyroidectomy with bilateral central and left modified radical neck dissection, followed by planned palliative resection of the shoulder metastasis and systemic therapy with a selective RET inhibitor. Conclusion: This case highlights a critical diagnostic pitfall. Metastatic MTC can present as a massive soft tissue neoplasm mimicking a primary sarcoma. In such cases, a systematic diagnostic approach combining serum biomarkers (Calcitonin, CEA) with a comprehensive immunohistochemical panel is essential to establish the correct diagnosis and initiate appropriate, life-extending targeted therapy.

Efficacy of the Full Mesenchymal Stromal Cell Secretome versus Purified Small Extracellular Vesicles in Preclinical Models of Erectile Dysfunction: A Systematic Review and Parallel Meta-Analysis Victor Jeremia Syaropi Simanjuntak; Ishak Andreas Soritua Lumban Gaol; Erlangga Pradipta H; Dimas Sindhu Wibisono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1496

Background: Acellular therapies from Mesenchymal Stromal Cells (MSCs), including the full secretome (conditioned medium, CM) and purified small extracellular vesicles (sEVs), are promising restorative treatments for erectile dysfunction (ED). It remains unknown if the therapeutic benefit is driven by the complete secretome or if purified sEVs are the primary, sufficient component. This study aimed to systematically review and meta-analyze the preclinical evidence. Methods: We conducted a systematic review and parallel meta-analysis adhering to PRISMA guidelines. PubMed, Scopus, and Web of Science were searched from January 1st, 2014, to July 31st, 2025. Studies were eligible if they were preclinical ED models evaluating MSC-CM or purified sEVs against a control. Two parallel meta-analyses were performed using a random-effects model. Primary outcomes were erectile function (Intracavernous Pressure / Mean Arterial Pressure ratio; ICP/MAP) and histopathology (Smooth Muscle / Collagen ratio; SM/Col). Results: Our search yielded 1,942 records, with 87 full-text articles assessed. After applying strict PICO criteria, 7 primary studies were eligible for the meta-analysis (3 secretome, 4 sEVs). The overall risk of bias was moderate to high (0% allocation concealment). No studies directly compared secretome versus sEVs. The first meta-analysis (Secretome vs. Control, 3 studies, 4 data points, n=70) demonstrated a large, significant improvement in ICP/MAP (Standardized Mean Difference [SMD]: 2.40; 95% CI [1.65, 3.15]; p-value < 0.001), with extreme heterogeneity (I-squared=85%). The second meta-analysis (sEVs vs. Control, 4 studies, n=68) also showed a large, significant improvement (SMD: 2.75; 95% CI [1.90, 3.60]; p-value < 0.001), also with extreme heterogeneity (I-squared=88%). Conclusion: Both the full MSC secretome and purified sEVs demonstrate large, significant therapeutic effects. However, this quantitative conclusion is severely limited by the exceptionally small number of studies and the profound biomolecular heterogeneity (in cell source and purification) that invalidates direct comparison. The primary finding remains the total lack of comparative data.

Inadequate Preoperative Assessment and Its Clinicopathological Correlates in Patients Referred for Completion Thyroidectomy: A Tertiary Referral Center Analysis Munawar; R Maman Abdurrahman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1497

Background: Completion thyroidectomy (CT) for differentiated thyroid carcinoma (DTC) is a high-risk procedure, frequently performed following an oncologically incomplete primary operation. This study characterizes the preoperative diagnostic assessment deficiencies in a cohort of DTC patients referred to a tertiary center for re-operation and identifies factors associated with residual disease. Methods: We conducted a retrospective, single-center analysis of all patients who underwent CT for DTC at Hasan Sadikin General Hospital, Indonesia, over a 30-month period (January 1st, 2023, to June 30th, 2025). Data on preoperative assessments at the referring hospitals (ultrasonography (US) quality, fine-needle aspiration biopsy (FNAB), hormonal tests), primary surgical indications, and clinicopathological outcomes from both operations were extracted and analyzed using descriptive and bivariate statistics (Fisher's Exact Test). Results: A total of 27 patients met the inclusion criteria. Analysis of their initial workup revealed significant omissions: 14/27 (51.9%) lacked FNAB, and 5/27 (18.5%) lacked hormonal testing. While 24/27 (88.9%) underwent a primary US, only 20.8% of these reports (5/24) were ATA-compliant staging examinations. Only 5/27 patients (18.5%) received a complete trimodal assessment. Upon re-operation, 10/27 (37.0%) had residual carcinoma. This finding was significantly associated with the omission of primary FNAB (57.1% vs. 15.4%, p = 0.027). Conclusion: In this cohort of referred patients, incomplete preoperative assessment was nearly universal and strongly associated with adverse pathological findings. These data highlight the urgent need for standardized, evidence-based preoperative protocols and strengthened referral systems to ensure patients receive the correct primary operation.

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Rachmat Hidayat

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Kab. ogan ilir,

Sumatera selatan

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