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INDONESIA
Cermin Dunia Kedokteran
Published by PT. Kalbe Farma Tbk.
ISSN : 0125913X     EISSN : 25032720     DOI : 10.55175
Core Subject : Health,
Health Professions
Cermin Dunia Kedokteran (CDK) is a Medical Journal published since 1974 and affiliated with PT Kalbe Farma Tbk. CDK is intended to help accommodate scientific publications and help increase and disseminate knowledge related to the development of medical science, pharmacy, and public health. CDK covers the disciplines of medicine, pharmacy, and health with several types of articles, namely: 1. Research 2. Literature review 3. Case report 4. Evidence-based case report (EBCR), systematic review 5. Other scientific articles Based on the SK Kemendikbudristek Nomor 152/E/KPT/2023, CDK has obtained Rank 4 (SINTA 4) for Scientific Journals.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 1,288 Documents
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Tinjauan Klinis CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) Danar Dwi Anandika
Cermin Dunia Kedokteran Vol 48 No 8 (2021): Continuing Medical Education - Edisi 3
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i8.108

Abstract

CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) adalah penyakit herediter langka dengan prevalensi 4,14 per 100.000. Penyakit ini disebabkan mutasi gen Notch 3 pada kromosom 19. Manifestasi klinisnya bervariasi dengan onset gejala awal migrain dengan aura. Pada tahap lanjut akan dijumpai lesi infark multipel di area subkortikal. Pasien juga dapat mengalami gangguan psikiatri dan neurobehaviour. Tidak ada terapi kausal, dapat diberikan terapi simptomatik. CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) is a rare hereditary disease with a prevalence of 4.14 per 100,000. The disease is caused by a mutation of the Notch 3 gene on chromosome 19. The clinical manifestations vary with the onset of initial symptoms is migraine with aura. In advanced stages, there will be multiple infarct lesions in the subcortical area. Patients may also experience psychiatric and neurobehavioral disorders. There is no causal therapy, only symptomatic therapy.
Pengaruh Coronavirus Disease 2019 (COVID-19) terhadap Insidens dan Tatalaksana Penyakit Serebrovaskular Billy Priyanto Hamidjoyo; Budi Riyanto Wreksoatmodjo
Cermin Dunia Kedokteran Vol 48 No 8 (2021): Continuing Medical Education - Edisi 3
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i8.109

Abstract

COVID-19 dikenal dengan manifestasi klinis terkait saluran pernapasan seperti batuk, sesak, dan demam. Namun, saat ini telah banyak diteliti bahwa COVID-19 dapat menimbulkan gejala di luar sistem pernapasan, salah satunya ke sistem saraf. Pelaporan kejadian stroke pada pasien COVID-19 masih bervariasi, namun pada pasien COVID-19, khususnya yang bergejala berat terdapat kondisi hiperkoagulasi yang dapat menyebabkan komplikasi trombotik seperti trombosis vena dalam dan diduga berkaitan dengan risiko stroke pada pasien COVID-19. COVID-19 is known for its clinical manifestations related to the respiratory tract such as cough, shortness of breath, and fever. However, currently it has been widely studied that COVID-19 can cause symptoms outside the respiratory system, one of which is the nervous system. Reports of stroke events in COVID-19 patients still vary, but in COVID-19 patients, especially those with severe symptoms, there is a hypercoagulable condition that can cause thrombotic complications such as deep vein thrombosis and is thought to be associated with the risk of stroke in COVID-19 patients.
Aspek Neurobiologi dan Neuroimaging Bunuh Diri Dian Oktaria Safitri; AAAA. Kusumawardhani
Cermin Dunia Kedokteran Vol 48 No 8 (2021): Continuing Medical Education - Edisi 3
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i8.110

Abstract

Sejumlah 50% pelaku bunuh diri pernah melakukan percobaan bunuh diri sebelumnya. Sulitnya prediktor klinis dan tidak terdapatnya biomarker spesifik, menyulitkan prediksi perilaku bunuh diri. Perkembangan neurobiologi dan neuroimaging dapat memprediksi terjadinya upaya bunuh diri. Fifty percent individuals who committed suicide have previously conducted suicide attempts. Rare clinical predictors and the absence of specific biomarkers, lead to difficulties in predicting suicidal behavior. Neurobiology and neuroimaging may predict the occurrence of suicide.
Sklerosis Multipel: Diagnosis dan Tatalaksana Jimmy Christianto Suryo
Cermin Dunia Kedokteran Vol 48 No 8 (2021): Continuing Medical Education - Edisi 3
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i8.111

Abstract

Sklerosis multipel adalah lesi multipel sistem saraf pusat akibat rusaknya selubung mielin yang membungkus akson. Penyakit ini termasuk penyakit neurodegeneratif bersifat progresif dan relaps, sering mengenai wanita dewasa muda, memerlukan penanganan komprehensif dan sistematis. Penyebab penyakit belum diketahui pasti, diduga berkaitan dengan faktor infeksi virus atau proses autoimun atau genetik. Manifestasi klinisnya bervariasi. Kriteria diagnosis terbaru didasarkan pada Kriteria McDonald tahun 2017. Tatalaksana mencegah relaps dan progresivitas menggunakan corticosteroid, imunosupresan, imunomodulator, plasmapheresis (pertukaran plasma), atau DMAMS (Disease-Modifying Agent for Multiple Sclerosis), atau stem cell therapy. Prognosis tergantung komplikasi, progresivitas penyakit, dan pilihan terapi. Multiple sclerosis is multiple lesions of the central nervous system due to damage to the axons’ myelin sheaths. This neurodegenerative disease is progressive and relapsing, often affecting young adult women, requiring comprehensive and systematic management. It is thought to be related to viral infection factors or autoimmune or genetic processes. The clinical manifestations are not typical depending on the brain lesion and disease progression. The latest diagnosis criteria are based on the 2017 McDonald Criteria. Management are to prevent relapse and progression using corticosteroids, immunosuppressants, immunomodulators, plasmapharesis (plasma exchange), or DMAMS (Disease-Modifying Agent For Multiple Sclerosis), or stem cell therapy. Prognosis depends on the complications, disease progression, and appropriate treatment options.
Diagnosis dan Tatalaksana Kegawatdaruratan Hiperkalemia Gloria Teo
Cermin Dunia Kedokteran Vol 48 No 8 (2021): Continuing Medical Education - Edisi 3
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i8.112

Abstract

Hiperkalemia ialah kadar kalium plasma/ serum yang melebihi batas atas rentang normal, yaitu ≥5,5 mEq/L; dapat bervariasi tergantung cut off laboratorium dan sampel pemeriksaan. Hiperkalemia sering dijumpai di instalasi gawat darurat (IGD). Hiperkalemia berat dapat meningkatkan risiko mortalitas hingga 30%, karena menyebabkan aritmia yang mengancam nyawa, seperti fibrilasi ventrikel dan asistol. Hiperkalemia dapat disebabkan oleh perpindahan K+ intraseluler menuju ekstraselular, ekskresi inadekuat, dan intake K+ berlebih pada pasien gangguan ginjal. Tatalaksana hiperkalemia meliputi upaya menstabilkan miokard dan mencegah/ memperbaiki disritmia, redistribusi/pemindahan K+ menuju intraseluler, serta meningkatkan ekskresi K+. Hyperkalemia is defined as a serum or plasma potassium level above the upper limits of normal range, usually ≥5,5 mEq/L; may vary depending on each laboratory cut off and sample. Hyperkalemia is the most common electrolyte disorder in emergency department. Severe hyperkalemia may increase the mortality up to 30% due to fatal arrhythmia, such as ventricular fibrillation and asystole. Hyperkalemia might be caused by potassium shift to extracellular compartment, inadequate excretion, and increased potassium intake in patients with decreased renal function. Management of hyperkalemia include myocardial stabilization and preventing/ improving dysrhythmia, redistribution/ shifting potassium back to intracellular compartment, and increasing potassium excretion.
Tatalaksana Nyeri Neuropatik Perifer dengan Sediaan Patch Lupita Wijaya
Cermin Dunia Kedokteran Vol 48 No 9 (2021): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i9.113

Abstract

Obat-obat oral seperti antidepresan trisiklik, antikonvulsan (gabapentin dan pregabalin), dan SSRI (selective serotonin reuptake inhibitors), masih menjadi pilihan pertama yang direkomendasikan oleh pedoman internasional dan Eropa untuk terapi nyeri neuropatik. Namun, penurunan nyeri hanya sebesar 30-40% dan sering disertai efek samping sistemik. Obat topikal sediaan patch menjadi salah satu terapi alternatif. Oral drugs like tricyclic antidepressant, anticonvulsants (gabapentin and pregabalin), and SSRI (selective serotonin reuptake inhibitors), still become first choice as recommended by international and Europe therapy guidelines for neuropathic pain. However, the regimen is effective in only about 30-40% cases and often has undesirable systemic adverse effects. Topical drugs in patch form can be one of alternative therapy for neuropathic pain.
Pendekatan Klinis Pasien Transthyretin Cardiac Amyloidosis (ATTR-CA) Nur Adiba Purba
Cermin Dunia Kedokteran Vol 48 No 9 (2021): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i9.114

Abstract

Transthyretin Cardiac Amyloidosis (ATTR-CA) adalah penumpukan fragmen protein transthyretin di jaringan interstisial miokardium akibat salah lipat protein, menyebabkan kardiomiopati restriktif dan infiltratif karena penebalan dan kekakuan dinding jantung. Transthyretin sebagian besar diproduksi di hati, berbentuk tetramer dan berfungsi sebagai protein pembawa tiroksin (T4) serta holoretinol binding protein (HRP). Saat ini, pemeriksaan diagnostik metode non-invasif telah dikembangkan meskipun biopsi endomiokardium masih menjadi gold standard diagnosis. Diagnosis akurat sedini mungkin sangat berpengaruh terhadap keberhasilan serta penurunan angka morbiditas dan mortalitas. Transthyretin Cardiac Amyloidosis (ATTR-CA) is the accumulation of transthyretin protein fragment in myocardium interstitial tissue induced by misfolded protein, lead to thickening and stiffness cardiac muscles, causing restrictive and infiltrative cardiomyopathy. Transthyretin is produced mainly in the liver as tetramer and bonded both with thyroxine (T4) and holoretinol binding protein (HRP) as carrier protein. Diagnostic test with non-invasive methods have been developed recently although endomyocardial biopsy is still the gold standard. Early targeted diagnosis has huge impact for therapy management and decreasing patient’s morbidity and mortality.
Tinjauan atas Retinopati Valsalva Rabiul Priyantono; Nassa Rachmatika Meylani
Cermin Dunia Kedokteran Vol 48 No 9 (2021): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i9.115

Abstract

Retinopati Valsalva adalah penyakit dengan gambaran perdarahan lapisan subhyaloid atau sub-Internal Limiting Membrane (ILM) retina yang disebabkan oleh aktivitas mirip manuver Valsalva seperti batuk, mengejan, muntah, atau latihan fisik yang kuat. Keluhan berupa penurunan tajam penglihatan mendadak mulai dari ringan sampai berat, bahkan hilangnya tajam penglihatan. Penyakit ini belum diketahui epidemiologinya. Perdarahan bisa mengalami resolusi dalam beberapa minggu atau beberapa bulan. Tindakan laser atau pembedahan dibutuhkan jika perdarahan cukup banyak atau tidak terjadi resolusi. Valsalva retinopathy is hemorrhage in subhyaloid or sub-Internal Limiting Membrane (ILM) layer in retina, caused by Valsalva maneuver-like activity such as cough, straining, vomiting, or vigorous physical activity. The symptom is mild to severe sudden painless decreased visual acuity, even loss of vision. The epidemiology of this disease is unknown. Hemorrhage in retinal layer can be resolved in weeks to months. Laser treatment or surgical treatment can be considered if in massive hemorrhage, or no resolution after observation.
Efek Samping Steroid Sistemik pada Terapi Pemvigus Vulgaris Felicia Aviana; I Made Birawan
Cermin Dunia Kedokteran Vol 48 No 9 (2021): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i9.117

Abstract

Pemfigus vulgaris (PV) adalah penyakit autoimun vesikobulosa pada kulit dan membran mukosa yang secara histologi ditandai bula intraepidermal yang disebabkan oleh akantolisis. Steroid sistemik merupakan terapi utama PV. Artikel ini membahas efek samping terapi steroid parenteral pada pemfigus vulgaris. Pemphigus Vulgaris (PV) is an autoimmune blistering disease of skin and mucous membranes, histologically defined by intraepidermal blister due to acantholysis. Systemic steroid is the first-line treatment in PV. This article briefly discussedthe adverse effect of parenteral steroid in the treatment of pemphigus vulgaris.
Hubungan antara Konstipasi dengan Akne Vulgaris dan Derajat Keparahannya pada Mahasiswa Kedokteran di Jakarta Anastasia Rena Renate; Julia Rahadian Tanjung
Cermin Dunia Kedokteran Vol 48 No 9 (2021): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i9.118

Abstract

Latar Belakang: Teori koneksi organ otak-usus-kulit menunjukkan hubungan erat antara kondisi usus dan kondisi dermatologis. Keadaan konstipasi dapat menyebabkan produk sekretori usus menuju peredaran sistemik yang dapat meningkatkan inflamasi organ kulit, sehingga rentan terhadap akne vulgaris. Metode: Penelitian cross-sectional pada 100 mahasiswa laki-laki usia 17-22 tahun dengan metode stratified random sampling. Penilaian konstipasi menggunakan kuesioner gejala konstipasi berdasarkan Kriteria Rome III dan penilaian derajat keparahan akne vulgaris menggunakan Evaluator Global Severity Score (EGSS). Hubungan antara variabel independen dan dependen diuji menggunakan Chi-Square dan Fisher-exact. Hasil: Didapatkan 100 responden, usia terbanyak yang mengalami akne vulgaris adalah 19 tahun dan usia terbanyak yang mengalami konstipasi adalah 20 tahun.Terdapat hubungan bermakna antara konstipasi dan akne vulgaris (p=0,012). Berdasarkan derajat keparahannya, tidak terdapat hubungan antara konstipasi dan akne vulgaris derajat ringan (p=0,973) namun terdapat hubungan antara konstipasi dan akne vulgaris derajat sedang – berat (p=0,048). Simpulan: Penelitian ini menunjukkan hubungan bermakna antara konstipasi dan akne vulgaris.   Background: The theory of brain-intestinal-skin connections shows a relationship between intestinal and dermatological conditions. Constipation stimulate the intestine secretory products towards systemic circulation and increase inflammation of the skin, acne vulgaris. Method: This cross-sectional study involved 100 male students aged 17-22 years with stratified random sampling method. Constipation assessment used constipation questionnaire based on Rome III Criteria and assessment for severity of acne vulgaris used Evaluator Global Severity Score (EGSS). The relationship between independent and dependent variables was tested using Chi-Square and Fisher-exact. Result: Majority respondents who have acne vulgaris is 19 year-old and constipation is mostly found in 20 year-old. There is significant relationship between constipation and acne vulgaris (p=0.012). No significant relationship between constipation and mild acne vulgaris (p=0.973) but there is a significant relationship between constipation and moderate to severe acne vulgaris (p=0.048). Conclusion: This study shows possible role of digestive organ health in acne vulgaris incidence.

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