Medical Journal of Indonesia最新文献

{"title":"Association of P-glycoprotein expression and response to anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer","authors":"E. D. Yulian, Filipus Dasawala, N. Siregar","doi":"10.13181/mji.oa.225863","DOIUrl":"https://doi.org/10.13181/mji.oa.225863","url":null,"abstract":"BACKGROUND Neoadjuvant chemotherapy (NACT) has been shown to improve the overall survival of locally advanced breast cancer (LABC) patients with pathological complete response. However, the efficacy may be reduced due to chemoresistance mediated by P-glycoprotein (Pgp). This study aimed to explore the association between Pgp expression and patients’ response to NACT. \u0000METHODS A prospective cohort study was carried out from May 2018 to October 2019 at Cipto Mangunkusumo Hospital and Koja Hospital. Treatment-naïve LABC patients were consecutively enrolled in the study. Immunohistochemistry analysis of the biopsy samples was done to semi-quantitatively measure Pgp expression. The clinical response was evaluated after 3 cycles of NACT, while the pathological response was evaluated for subjects who underwent surgery post-NACT. \u0000RESULTS Mean age of the subjects was 46.2 (9.6) years old, and most of the cases were invasive ductal (78%) and luminal B subtype (61%). Pgp was strongly expressed in 21/27 subjects (78%). There were no differences between Pgp-positive and -negative subjects for clinical response (relative risk [RR] 1.1, 95% confidence interval [CI] 0.33–4.01, p = 0.61) and pathological response (RR 1.3, 95% CI 0.8–1.9, p = 0.22). Other clinicopathologic variables were not associated with either clinical or pathological responses. \u0000CONCLUSIONS These results showed that Pgp is expressed in most LABC patients, but its role as a predictive factor could not be established. However, due to the limited subjects and a lack of standardized Pgp measurement, careful consideration must be done when interpreting these results.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49183294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procalcitonin prognostic value in predicting mortality among adult patients with sepsis due to Gram-negative bacteria","authors":"Bonita Effendi, C. Pitoyo, R. Sinto, S. Suwarto","doi":"10.13181/mji.oa.225864","DOIUrl":"https://doi.org/10.13181/mji.oa.225864","url":null,"abstract":"BACKGROUND Sepsis is a leading cause of mortality and morbidity globally. Gram-negative bacteremia was reported to have a high risk of septic shock and poor prognosis. This study aimed to evaluate the role of procalcitonin in predicting mortality in patients with sepsis due to Gram-negative bacteria. \u0000METHODS This was a retrospective cohort study performed based on medical records and sepsis registry of Tropical and Infectious Disease Division, Department of Internal Medicine, Cipto Mangunkusumo Hospital. The inclusion criteria were patients aged ≥18 years diagnosed with sepsis due to Gram-negative bacteria based on blood culture on admission and hospitalized between March 2017 and October 2020. Data taken from medical records included subjects’ characteristics, laboratory parameters, and 28-day mortality outcomes during hospitalization. Receiver operating characteristic was used to determine the area under the curve (AUC) of procalcitonin and its accuracy. \u0000RESULTS A total of 128 patients were eligible. The cumulative survival of patients with Gram-negative bacteremia was 48.4% (standard error 0.96%). The AUC of procalcitonin to predict mortality was 0.45 (95% confidence interval 0.36–0.54). Escherichia coli was the predominant microorganism in blood culture (n = 38, 29.7%). \u0000CONCLUSIONS Procalcitonin has a poor performance in predicting mortality of patients with sepsis due to Gram-negative bacteria.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48383598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Omicron surge and the future of COVID-19 vaccinations","authors":"E. Burhan, Rizky Abi Rachmadi","doi":"10.13181/mji.bc.226066","DOIUrl":"https://doi.org/10.13181/mji.bc.226066","url":null,"abstract":"The global surge of Omicron has caused significant concern. Omicron has caused new wave of infections in nations with adequate vaccine coverage. Omicron has around 30 mutations that are similar to the previous variant of concerns, possibly decreasing vaccine effectiveness (VE). Hence, the emergence of Omicron is predicted to be a significant public health challenge and may alter the future of COVID-19 vaccinations. Furthermore, other issues may affect vaccine policy in the future such as the never-ending vaccine inequity, waning immunity of current COVID-19 vaccines, decreasing VE against new emerging strains, and new findings regarding hybrid immunity. This literature review aimed to explore the possible steps forward using the most updated knowledge on COVID-19 vaccines and Omicron.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45908314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethicomedicolegal aspects of the COVID-19 health services in preparing regulations and intermediaries for clinical dispute resolution: a systematic review","authors":"Agus Purwadianto, A. Sugiharto, Fitri Ambar Sari, Roberia, Uud Cahyono, Yuli Budiningsih, Denys Putra Alim, Nadia Ulfah Faddila","doi":"10.13181/mji.oa.225718","DOIUrl":"https://doi.org/10.13181/mji.oa.225718","url":null,"abstract":"BACKGROUND The COVID-19 pandemic has caused many medical, ethical, and medicolegal changes, including constant adjustments in service guidelines. Continuing to revise healthcare regulations and guidelines can potentially cause clinical disputes or medical negligence that require ethical and legal solutions. This study aimed to determine the ethical and medicolegal aspects of the potential factors that cause clinical disputes during the pandemic and provide anticipative solutions to national ethicomedicolegal policies. \u0000METHODS A systematic literature search in PubMed, ScienceDirect, ClinicalKey, and Google Scholar was performed using keywords “clinical dispute,” “ethics,” “medicolegal,” “ethicolegal,” and “COVID-19”. The inclusion criteria were articles that contained information on shortage, justice, ethical distribution in intensive care, the possibility of lawsuits and disputes among stakeholders during the pandemic, and stakeholders’ roles in managing the pandemic. Key evidence was analyzed and synthesized following national ethicomedicolegal policies. \u0000RESULTS We identified 19 articles from the 4 databases. Based on the literature, the main ethicomedicolegal impact of the COVID-19 pandemic appears in 3 aspects: (1) a shortage of fair and ethical intensive care services with fair and ethical distribution efforts, (2) legal protection for medical personnel from legal charges while providing health services during the pandemic, and (3) the government’s role in managing the pandemic together with the stakeholders involved. \u0000CONCLUSIONS Ethicomedicolegal clinical dispute management and its norms require an update, especially when deciding the complexity of COVID-19 service standards. Ethicomedicolegal professionals are needed as intermediaries to manage cases of clinical disputes and to implement fair malpractice criteria in Indonesia.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42124974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of immediate electrical stimulation in the distal segment of the nerve with Wallerian degeneration in rats with sciatic nerve injury","authors":"A. R. Hamid, S. Maliawan, D. Samatra, N. Astawa, I. Bakta, I. M. Jawi, Ida Bagus Putera Manuaba, I. D. M. Sukrama, D. S. Perdanakusuma","doi":"10.13181/mji.oa.225870","DOIUrl":"https://doi.org/10.13181/mji.oa.225870","url":null,"abstract":"BACKGROUND Electrical stimulation in the proximal segment is one of the modalities for peripheral nerve injury, although it is prone to cause excessive axonal sprouting growth in the proximal segment of the nerve. This study aimed to show that immediate electrical stimulation in the distal segment of the sciatic nerve in Wistar rats accelerated Wallerian degeneration by increasing the expression of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-10, and galectin-3/MAC-2 macrophages to avoid sprouting axons excessively in the proximal segment. \u0000METHODS This was an experimental study using male Wistar rats (Rattus norvegicus) with a randomized post-test only control group design. The treatment group received immediate electrical stimulation (20 Hz, 2 mA, for 5 sec) to the distal nerve after sciatic nerve injury, while the control group received no treatment. After 3 days, tissue samples were extracted from the distal segment of the sciatic nerve to examine the level of TNF-α, IL-10, and galectin 3/Mac-2 macrophages using ELISA and from proximal nerves to histologically examine the sprouting axons. \u0000RESULTS Rats in the treatment group had higher TNF-α (52.1 [10.32] versus 40.4 [17.71] pg/100 mg, p = 0.031) and higher IL-10 (918 [167.6] versus 759 [158.9] pg/ml, p = 0.010). Expression of galectin 3/Mac-2 macrophages was similar in both groups (465 [49.5] versus 444 [54.4] pg/100 mg, p = 0.247). The number of sprouting axons was lower in the treatment group (2 [IQR 1–2] versus 2.5 [IQR 2–3], p = 0.003). \u0000CONCLUSIONS Immediate electrical stimulation in the distal segment of the sciatic nerve can accelerate nerve regeneration.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48310005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac manifestations and diagnostic imaging in pediatric inflammatory multisystem syndrome temporally associated with COVID-19: a systematic review","authors":"G. Octavius, R. Tan, Teodorus Alfons Pratama, C. L. Budiputri, Fellisa Meliani, R. Heriyanto, R. Muljadi, A. Juliansen","doi":"10.13181/mji.oa.225754","DOIUrl":"https://doi.org/10.13181/mji.oa.225754","url":null,"abstract":"BACKGROUND Several studies have reported pediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS) cases with their cardiac manifestations, but only few studies synthesize the cardiovascular characteristics in children with PIMS-TS. However, detecting cardiac abnormalities is crucial in improving patients' outcomes and reducing mortality. This review aimed to summarize the overall symptoms, laboratory, and workup findings in PIMS-TS patients, focusing on cardiovascular manifestations. \u0000METHODS We searched 4 medical databases (PubMed, Science Direct, Medline, and Scielo) and 4 preprint databases (Medrxiv, Research Square, SSRN, and Biorxiv). The literature search was done on November 8, 2021. All case reports, case series, cross-sectional studies, cohort studies, and possible clinical trials published from December 2020 onward that studied PIMS-TS on cardiac manifestation (aged 0–18 years) were included. Studies on multisystem inflammatory syndrome in children, animal studies, and studies without full-text availability were excluded. This review was registered in PROSPERO (CRD42021194468). \u0000RESULTS 59 studies were included with a total of 698 patients. The most common cardiovascular findings were the presence of cardiogenic shock (37%) and hypotension (8.5%). Almost all laboratory values were deranged. Cardiac computed tomography scan mostly showed normal results (56%), followed by cardiomegaly with pericardial effusion (14%). Electrocardiography showed normal findings (46%), ST-segment abnormalities (32%), and abnormal T wave (12%). Echocardiography findings showed left ventricle dysfunction (40.6%), which can be considered most significant, followed by pericardial effusion together with pericarditis (11.4%) and tricuspid regurgitation (6.9%). \u0000CONCLUSIONS This review found various cardiac abnormalities that may develop during PIMS-TS. Due to these findings, we should be more vigilant and not underestimate the consequences in pediatric COVID-19 patients.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48338127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zoom fatigue and its risk factors in online learning during the COVID-19 pandemic","authors":"Jonathan Salim, Sutiono Tandy, J. Arnindita, Jacobus Jeno Wibisono, Moses Rizky Haryanto, Maria Georgina Wibisono","doi":"10.13181/mji.oa.225703","DOIUrl":"https://doi.org/10.13181/mji.oa.225703","url":null,"abstract":"BACKGROUND Global nations have enforced strict health protocols because of the COVID-19’s high transmission, infectivity, and mortality. As shown by increased online learning and video conferencing, the employment and education sectors are shifting to home-based activities. Video conferencing as a communication medium has subtly led to zoom fatigue. This study aimed to analyze the risk factors of zoom fatigue for early prevention and treatment. \u0000METHODS This cross-sectional study was conducted on 335 Indonesian university students selected by purposive sampling in July 2021. Data were collected using a demographic questionnaire including online courses duration during the COVID-19 pandemic; Pittsburgh sleep quality index; depression, anxiety and stress scale-21; and zoom & exhaustion fatigue (ZEF) scale through Google Form (Google LLC, USA) distributed via social media and student forums. Association and correlation tests were used, and the model was developed using linear regression. \u0000RESULTS The respondents were aged 21.3 (1.8) years with 12.8 (5.1) months of online courses during the COVID-19 pandemic and a ZEF scale of 2.8 (0.9). Students with higher ZEF had irregular physical exercise, poorer sleep quality, longer video conferencing sessions, longer months of courses during the COVID-19 pandemic, and higher mental illness (i.e., stress, anxiety, and depression). Smoking negatively correlated with fatigue (r = −0.12). The model for ZEF showed good predictability for zoom fatigue (p<0.001, R2 = 0.57). \u0000CONCLUSIONS Daily exposure to video conferencing in educational settings throughout the pandemic has drastically increased zoom fatigue. The stakeholders must act immediately to minimize the risks while providing maximum benefits.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43022065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of identification for a stress urinary incontinence after pelvic organ prolapse vaginal repair","authors":"Hariyono Winarto","doi":"10.13181/mji.ed.215971","DOIUrl":"https://doi.org/10.13181/mji.ed.215971","url":null,"abstract":"[No abstract available]","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42920342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception and preventive behavior during COVID-19 pandemic among urban residents in Banda Aceh, Indonesia: a cross-sectional study","authors":"Husnah, Liza Salawati, Sakdiah, Nurul Nazira, Sarah Firdausa, Y. Nawawi","doi":"10.13181/mji.oa.215674","DOIUrl":"https://doi.org/10.13181/mji.oa.215674","url":null,"abstract":"BACKGROUND It is critical to evaluate the perception and preventive behavior of COVID-19 to formulate the optimal public health strategies for tackling the ongoing pandemic. This study aimed to enhance knowledge on the perception and preventive behavior toward COVID-19 among urban residents in Banda Aceh, Indonesia. \u0000METHODS A cross-sectional population-based survey was conducted from September to October 2020 using a structured questionnaire for the attendants of the six public health centers in Banda Aceh. Information about sociodemographic, perception, and preventive behavior toward COVID-19 were collected. The data were analyzed to find the association between the level of preventive behavior and covariates. \u0000RESULTS Among 1,067 respondents, 71.1% were female, 52.5% were aged between 40 and 60 years, 31.2% were university graduates, and >60% were unemployed with underlying diseases such as diabetes, hypertension, and cardiopulmonary diseases. The responses of each statement toward COVID-19 were varied. The multivariable model of covariates showed that females had good preventive behavior toward COVID-19 (adjusted OR: 1.849, 95% CI: 1.359–2.515). Urban residents in Banda Aceh with the underlying diseases had poor preventive behavior, while those with higher educational level and perception scores were more inclined to engage in good preventive behavior. \u0000CONCLUSIONS Most urban residents in Banda Aceh showed positive perception and propensity for adopting preventive measures. Health education is necessary for susceptible residents, such as males, less educated people, and people with underlying diseases. It should be stressed on specific practices and knowledge.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43230828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 potentially causes long-term deterioration of lung function: a systematic review and meta-analysis","authors":"Y. Patria, Rahmaningsih Mara Sabirin","doi":"10.13181/mji.oa.215660","DOIUrl":"https://doi.org/10.13181/mji.oa.215660","url":null,"abstract":"BACKGROUND The COVID-19 is an emerging disease that commonly involves respiratory complaints, including acute respiratory distress syndrome. The effect of COVID-19 on pulmonary function is still unclear and only based on sporadic reports with a small sample size. This study aimed to compile evidence on the pulmonary function of patients who have recovered from COVID-19. \u0000METHODS Literature searching was conducted in PubMed, Embase, Google Scholar, Scopus, Web of Sciences, and CINAHL. Any types of studies published before June 26, 2020 and reported lung function tests of post-COVID-19 patients were included. Articles reporting data from early hospitalization were excluded. The risk of bias was measured using tools developed by the Joanna Briggs Institute. Meta-analysis was done using a meta statistical package in R and presented in the random effects model. \u0000RESULTS 378 recovered COVID-19 patients in 7 studies were included. The lung function measurement periods were varied, ranging from 14 days after hospitalization to 10 weeks after receiving rehabilitation. Meta-analyses found that the pooled mean of diffusion capacity of carbon monoxide in recovered COVID-19 patients was lower than 80% predicted, whereas the other parameters were normal. The forced vital capacity and total lung capacity showing restrictive lung disorders were significantly lower in the severe COVID-19 survivors. \u0000CONCLUSIONS COVID-19 has a negative impact on lung function for at least several weeks in the recovery period. Diffusion and restrictive problems could be the main long-term consequences of COVID-19.","PeriodicalId":18302,"journal":{"name":"Medical Journal of Indonesia","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42064401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}