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"Latar Belakang Artritis reumatoid merupakan penyakit reumatik yang sering menyebabkan penurunan kualitas hidup. Metotreksat dilaporkan mempengaruhi perubahan kualitas hidup pasien AR. Penelitian ini bertujuan untuk mengetahui apakah terdapat perbedaan kualitas hidup Pasien AR dengan indikator EuroQol five dimensional (EQ-5D). Metode Penelitian Desain penelitian ini adalah studi potong lintang. Data merupakan data sekunder yang diambil dari penelitian besar Divisi Reumatologi, Departemen Ilmu Penyakit Dalam FKUI/RSCM. Sebanyak 153 subjek direkrut dari Poliklinik Reumatologi RSUPN dr. Cipto Mangunkusumo Jakarta. Kriteria inklusi meliputi pasien AR yang menggunakan metotreksat selama 6 bulan sebagai terapi tunggal DMARD untuk pertama kali, dan dapat dikombinasikan dengan terapi simptomatik dan terapi untuk komorbiditas. Data mengenai usia, jenis kelamin, durasi penyakit, derajat aktivitas penyakit, komorbiditas, serta dosis metotreksat bulan ke-0 dan bulan ke-6 diambil pada penelitian ini. Kualitas hidup sebelum dan sesudah pemberian metotreksat diukur dengan menggunakan kuesioner EQ-5D dan EQ global health visual analogue (EQ-VAS). Analisis perbedaan indeks EQ-5D dan EQ-VAS sebelum dan sesudah pemberian metotreksat dilakukan dengan uji beda dua kelompok berpasangan. Hasil Penelitian Sebanyak 90,2% perempuan dengan rerata usia 49,54 ± 12,22 tahun dengan tingkat pendidikan menengah dan tidak bekerja. Mayoritas subjek memiliki derajat aktivitas sedang (rerata 3,91 ± 0,94). Median skor rheumatic disease comorbidity index (RDCI) adalah 0 (0-4). Median indeks EQ-5D sebelum dan sesudah pemberian metotreksat adalah 0,835 ((-0,054) – 1) dan 0,914 (0,033 – 1), sedangkan median nilai EQ-VAS sebelum dan sesudah pemberian metotreksat adalah 70 (30-100) dan 75 (30-100). Ditemukan perbedaan kualitas hidup bermakna antara EQ-5D dan EQ-VAS sebelum dan sesudah pemberian metotreksat (p <0,001). Kesimpulan Terdapat perbaikan kualitas hidup pada pasien AR di RSCM antara sebelum dan sesudah pemberian metotreksat menggunakan instrumen EQ.

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Background Rheumatoid Artrhitis (RA) is a rheumatic disease which often leads to decreased quality of life. Methotrexate is reported to affect the change of health-related quality of life (HR-QoL) in RA patient. This study aims to evaluate HR-Qol by EuroQol five dimensional (EQ-5D).

Methods The study design used in this research is cross-sectional study. The data is secondary data which obtained from grand research held by Rheumatology Division, Department of Internal Medicine, Medical Faculty University of Indonesia, RSCM. One hundred and fifty three subjects from Rheumatology Clinic at dr. Cipto Mangunkusumo National General Hospital Jakarta were enrolled. The inclusion criteria include RA patient using methotrexate for 6 months as DMARD monotherapy for the first time, and can be combined with adjunctive therapi such as symptomatic therapy and therapy for comorbidities. Data about age, gender, duration of disease, degree of disease activity, comorbidities and dose of methotrexate when starting therapy and after six months were obtained. HRQol was assesed using EQ-5D and EQ global health visual analogue (EQ-VAS) questionnaire. Mean difference test between two paired groups were employed to analyse HRQoL difference before and after methotrexate administration.

Result Ninety percent were female with mean age 49,54 ± 12,22 years with secondary education level and unemployed. Majority had moderate disease activity (mean 3,91 ± 0,94). Median rheumatic disease comorbidity index (RDCI) was 0 (0-4). Median EQ-5D index before and after methotrexate administration was 0,835 ((-0,054) – 1) and 0,914 (0,033 – 1), and then median EQ-VAS index before and after methotrexate administration was 70 (30-100) and 75 (30-100). Significance difference was found between EQ-5D and EQ-VAS index before and after methotrexate administration (p <0,001).

Conclusion Significance difference was found in HR-QoL before and after methotrexate administration on RA patient in RSCM by EQ-5D instrument."

"Latar belakang: Periodontitis adalah penyakit inflamasi kronis yang menyebabkan kerusakan jaringan periodontal secara progresif. Artritis reumatoid (AR) adalah penyakit autoimun yang ditandai dengan inflamasi kronis pada sendi sinovial yang mengarah pada kerusakan kartilago dan jaringan tulang. Gejala periodontitis berat pada pasien AR ditemukan secara signifikan berhubungan dengan kenaikan Anti-Citrullinated Protein Antibody (ACPA) dan perubahan profil bakteri subgingiva red complex. Terapi metotreksat (MTX) digunakan sebagai anchor drug pada AR karena rasio efikasi dan toksisitas yang baik. Tujuan: Mendapatkan perbedaaan status periodontal Probing Depth (PD), Full mouth bleeding score (FMBS), dan ekspresi relatif bakteri red complex P.gingivalis (Pg), T.denticola (Td), T.forsythia (Tf) antara kelompok sampel sehat, periodontitis, periodontitis disertai AR yang belum diterapi dan sudah diterapi MTX 1 bulan. Metode: Studi potong lintang dengan empat kelompok sampel terdiri dengan sembilan sampel sehat, dua belas sampel periodontitis, sepuluh sampel periodontitis disertai AR belum dilakukan terapi, empat sampel periodontitis disertai AR yang sudah diterapi MTX satu bulan. Pengambilan sampel diperoleh dari plak subgingiva. Pengukuran klinis status periodontal mencakup probing depth dan full-mouth bleeding score. Ekspresi relatif bakteri red complex dan total bakteri diukur menggunakan RT-PCR. Hasil: Penilaian PD tidak ditemukan perbedaan bermakna antar semua pasangan kelompok periodontitis dengan AR (p>0,05). Penilaian FMBS terdapat perbedaan bermakna antara kelompok Periodontitis dengan kelompok periodontitis disertai AR yang belum diterapi MTX satu bulan(p<0,05). Ekspresi relatif total bakteri tidak ada perbedaan pada semua pasangan kelompok. Analisis komparatif bakteri red complex menunjukkan perbedaan antar kelompok periodontitis tanpa AR dan periodontitis disertai AR yg belum diterapi MTX. Kesimpulan: AR yang belum melakukan terapi dan sudah diterapi MTX 1 bulan tidak memperburuk status periodontal baik PD maupun FMBS. Ekspresi relatif bakteri red complex cenderung lebih tinggi pada periodontitis tanpa disertai AR.

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Background: Periodontitis is a chronic inflammatory disease that causes progressive damage to periodontal tissue. Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the synovial joints, leading to cartilage and bone tissue damage. Severe periodontitis symptoms in RA patients are significantly associated with elevated Anti-Citrullinated Protein Antibody (ACPA) levels and changes in the subgingival bacterial profile, particularly the red complex bacteria. Methotrexate (MTX) therapy is used as an anchor drug in RA due to its good efficacy-to-toxicity ratio. Objective: To evaluate the differences in periodontal status, including Probing Depth (PD), Full Mouth Bleeding Score (FMBS), and the relative expression of the red complex bacteria P. gingivalis (Pg), T. denticola (Td), and T. forsythia (Tf) between healthy, periodontitis, periodontitis with untreated RA, and periodontitis with RA treated with MTX for 1 month. Methods: A cross-sectional study with four sample groups: nine healthy samples, twelve periodontitis samples, ten periodontitis samples with untreated RA, and four periodontitis samples with RA treated with MTX for one month. Samples were taken from subgingival plaque. Clinical periodontal status was measured using probing depth and full-mouth bleeding score. The relative expression of red complex bacteria and total bacteria was measured using RT-PCR. Results: No significant difference in PD was found between all pairs of periodontitis groups with RA (p>0.05). Significant differences in FMBS were found between the periodontitis group and the periodontitis with untreated RA group after one month of MTX therapy (p<0.05). There were no significant differences in total bacterial expression between all pairs of groups. Comparative analysis of red complex bacteria showed differences between the periodontitis without RA group and the periodontitis with untreated RA group. Conclusion: RA patients who have not yet undergone therapy and those treated with MTX for 1 month do not worsen periodontal status, both in terms of PD and FMBS. The relative expression of red complex bacteria tends to be higher in periodontitis without RA."

"Artritis Reumatoid (AR) merupakan penyakit autoimun yang menyerang sendi. Di Indonesia, AR 0,5 – 1% penduduk Indonesia menderita AR pada tahun 2020. Penelitian Rotte, et al. menunjukkan adanya hubungan antara jumlah sendi dengan respons terapi tunggal MTX. Penelitian ini dilakukan untuk mengetahui apakah ada hubungan antara jumlah sendi dengan keberhasilan terapi MTX pada pasien AR di RSCM. Penelitian ini menggunakan data rekam medis pasien AR di RSCM sejak tahun 2020 hingga 2022. Penelitian ini dilakukan denga desain kohort retrospektif Data dianalisis menggunakan SPSS Versi 25 dan dilakukan uji normalitas distribusi data menggunakan Uji Saphiro-Wilk. Setelah dilakukan uji normalitas, data dianalisis dengan Uji Mann-Whitney untuk mengetahui hubungan jumlah sendi dengan keberhasilan terapi MTX pada pasien AR di RSCM. Hasil Uji normalitas menunjukkan bahwa data jumlah sendi dengan keberhasilan terapi tidak terdistribusi secara normal. Berdasarkan hasil Uji Komparatif Mann-Whitney menunjukkan adanya perbedaan yang bermakna antara kelompok berhasil dan tidak berhasil terapi (p < 0.05). Terdapat hubungan antara jumlah sendi yang terlibat dengan keberhasilan terapi MTX pada pasien Artritis Reumatoid.

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Rheumatoid arthritis (RA) is an autoimmune disease that affects the joints. In Indonesia, the prevalence of RA is 0.5 - 1% in 2020. Research by Rotte, et al. showed a relationship between the number of joints with the response to MTX monotherapy. This study was conducted to determine whether there is a relationship between the affected joints count and the success of MTX therapy in RA patients at RSCM. This study used medical records of RA patients at RSCM from 2020 until 2022. This study was conducted with a retrospective cohort design. Data were analyzed using SPSS Version 25 and normality test was carried out using the Shapiro-Wilk test. After the normality test was performed, the data were analyzed using the Mann-Whitney test to determine the relationship between the affected joints count and the success of MTX therapy in RA patients at RSCM. The results of the normality test showed that the data on the affected joints count are not normally distributed. Based on the results of the Mann-Whitney Test, there was a significant difference between the successful and unsuccessful treatment groups (p < 0.05). There is a relationship between the number of affected joints count and the success of MTX therapy in Rheumatoid Arthritis patients."

"ABSTRAK Koriokarsinoma merupakan keganasan yang sangat invasive berasal dari villi plasentra dan trofoblas. Mola invasif dan koriokarsinoma sangat reponsif terhadap kemoterapi dengan angka kesembuhan lebih dari 90 , yang memungkinkan tercapainya kesembuhan tanpa mengganggu fungsi reproduksi. Methotrexate MTX merupakan terapi yang sering digunakan pada beberapa keganasan dan merupakan protokol kemoterapi pada koriokarsinoma, namun MTX memiliki banyak efek samping. Berbagai penelitian pada setengah abad terakhir menunjukan fungsi penting nanokurkumin. Penelitian in vitro dan in vivo menujukkan perannya seperti anti inflamasi, pengeluaran sitokin, anti oksidan dan imunomodulator. Namun, sapai saat ini belum ada penelitian mengenai efek antikanker nanokurkumin pada koriokarsinoma. Penelitian eksperimental sederhana ini menggunakan uji Shapiro-Wilk, uji t sampel bebas, dan uji Anova One Way. Pada penelitianini, kami meneliti dan mebandingkan efek pemberian MTX atau kombinasi dengan nanokurkumin pada berbagai jalur sinyal. Pada penelitian ini, 4 kelompok sel BeWo diberikan kombinasi MTX dan nanokurkumin, 1 kelompok sel BeWo diberikan MTX sebagai control positif, dan 1 kelompok sel BeWo sebagai control negatif. Penelitian ini menunjukkan terdapat penurunan ekspresi telomerase, ekspresi NF- B, dan indeks proliferasi BrdU yang signifikan dengan pemberian kombinasi MTX dan nanokurkumin dibandingkan dengan MTX saja ABSTRACT Choriocarcinoma is a highly invasive malignant tumor arising from the placental villous and extravillous trophoblast. IM and CCA, which make up the majority of these tumors, are highly responsive to chemotherapy with an overall cure rate exceeding 90 , making it usually possible to achieve cure while preserving reproductive function. Methotrexate is a frequently used for the treatment of several malignancies and is part of the chemotherapy protocols used for choriocarcinoma; however, side-effect are common. Extensive research over the last half century has revealed important functions of nanocurcumin. Invitro and in vivoresearch has shown various activities, such as anti-inflammatory, cytokines release, antioxidant, and immunomodulatory. However, to date no study has been carried out to elucidate its anticancer activity of nanocurcumin in choriocarcinoma. In this study, we investigated and compared the effects of methotrexate alone or in combination with nanocurcumin on various signalling pathway. In this simple experiment stury, we used Saphiro-Wilk test, independent sample t test, and Anova One Way test to analize data. To study the potential cooperative effect of both against, 4 BeWo cell lines were treated with the combination of methotrexate and nanocurcumin, 1 BeWO cell line was treated with methotrexate alone as a positive control, and 1 BeWo cell line as a negative control. This study demonstrated significant reduction of telomerase activity, NF- B expression, and proliferation index BrdU of BeWo cell line treated with a combination of nanocurcumin and methotrexate compared with methotrexate alone. It shows that the effect of nanocurcumin and methotrexate are syngergistic suggest potential for the clinical use of methotrexate in combination with curcumin which will allow effective anticancer effect in choriocarcinoma. "

"Latar belakang. Anak dan remaja dengan leukemia limfoblastik akut (LLA) berisiko mengalami osteoporosis sekunder, salah satunya karena pemberian obat kemoterapi metotreksat dan steroid. Saat ini belum terdapat data prevalens osteoporosis sekunder pada anak dengan LLA di Indonesia dan bukti keterkaitan dosis kumulatif metotreksat dan steroid terhadap kejadian osteoporosis sekunder pada anak dengan LLA.Tujuan. Mengetahui ada tidaknya kaitan antara dosis kumulatif metotreksat dan/atau steroid terhadap kejadian osteoporosis sekunder pada anak dan remaja dengan LLA.Metode. Penelitian ini merupakan studi potong lintang terhadap 52 anak dan remaja dengan LLA yang sedang menjalani kemoterapi di Rumah Sakit dr. Cipto Mangunkusumo (RSCM). Pengambilan darah dan foto polos tulang belakang dilakukan untuk menilai parameter kesehatan tulang, serta pemeriksaan dual energy X-ray absorptiometry (DEXA) untuk menilai densitas mineral tulang. Analisis regresi logistik digunakan untuk menganalisis keterkaitan dosis kumulatif metotreksat dan steroid terhadap kejadian osteoporosis sekunder.Hasil. Median usia subyek adalah 10 (7-14) tahun dengan lelaki 54% (n=52). Didapatkan kejadian osteoporosis sekunder 6/52 (11,5%) dan densitas mineral tulang rendah 11/52 (21,2%). Tidak didapatkan kaitan antara dosis kumulatif steroid (adjusted RP 0,474 [0,057-3,935], p = 0,489) dan dosis kumulatif metotreksat (adjusted RP 0,083 [0,006-1,126], p = 0,061)  dengan kejadian osteoporosis sekunder. Pasien berusia di bawah 10 tahun, memiliki kadar vitamin D rendah, dan status prepubertas memiliki kecenderungan mengalami osteoporosis sekunder.Kesimpulan. Tidak didapatkan hubungan yang bermakna secara statistik antara dosis kumulatif steroid dan/atau metotreksat terhadap osteoporosis sekunder pada anak dan remaja dengan LLA.

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Background. Children and adolescents with acute lymphoblastic leukemia (ALL) are at risk of secondary risk, one of which is the administration of chemotherapy drugs (methotrexate and steroids). Currently, there are no data on the prevalence of secondary osteoporosis in children with ALL in Indonesia and evidence about association between methotrexate and steroids with the incidence of secondary osteoporosis with ALL.

Objective. To determine whether there is an association between the cumulative dose of methotrexate and/or steroids on the incidence of secondary osteoporosis in children and adolescents with ALL.

Methods. This study was a cross-sectional study of 52 children and adolescents with ALL who were undergoing chemotherapy at the Cipto Mangunkusumo Hospital (CMH). Blood sampling and plain radiographs of the spine were performed to assess bone health parameters, as well as dual energy X-ray absorptiometry (DEXA) examination to assess bone mineral density. Logistic regression analysis was used to analyze the association between the cumulative dose of methotrexate and steroids on the incidence of secondary osteoporosis.

Result. The median age of the subjects was 10 (7-14) years with 54% men (n=52). The incidence of secondary osteoporosis was 6/52 (11.5%) and low bone mineral density 11/52 (21.2%). There was no association between the cumulative dose of steroids (adjusted PR 1.501 [0.124-18.124], p=0.75) and the cumulative dose of methotrexate (adjusted PR 0.071 [0.005-0.951], p=0.05) and the incidence of secondary osteoporosis. None of the confounding factors (pubertal status, vitamin D levels, income level, age, and sex) were associated with secondary osteoporosis. Patient aged below 10 years old, have prepubertal status, and with low vitamin D serum tends to have osteoporosis more likely.

Conclusion. There was no statistically significant relationship between the cumulative dose of steroids and/or methotrexate on secondary osteoporosis in children and adolescents with ALL."