Background and Objectives: Myocardial bridging (MB) is still not yet considered a significant finding in Indonesia both radiographically and clinically. Hence, this article aims to assess the prevalence of MB using multi-detector computed tomography (MDCT) and look at factors contributing to stenosis amongst patients with MB. Materials and Methods: This study is cross-sectional in a single centre, with consecutive sampling, looking at all patients who underwent a multi-detector computed tomography (MDCT) scan from February 2021 until February 2023. GraphPad Prism version 9.0.0 for Windows (GraphPad Software, Boston, MA, USA) was used to analyse the results. Results: There are 1029 patients with an MB, yielding a prevalence of 44.3% (95%CI 42.3–46.4). The left anterior descending vessel is the most commonly implicated, with 99.6%. Among those with stenosis, the middle portion of the bridging vessel is the most common site of stenosis (n = 269), followed by the proximal portion (n = 237). The severity of stenosis is more often moderate, with 30–50% (n = 238). Females (odds ratio [OR] of 1.8, 95%CI 1.4–2.3; p-value < 0.0001), older age (t-value 5.6, p-value < 0.0001), symptomatic patients (OR 1.4, 95% CI 1.1–1.9; p-value = 0.013), and higher mean coronary artery calcium score (t-value 11.3, p-value < 0.0001) are more likely to have stenosis. The degree of stenosis is significantly higher in the proximal stenosis group than in the middle stenosis group (t-value 27, p-value < 0.0001). Conclusions: Our research demonstrates that MB may prevent atheromatosis of the coronary segment distal to the MB and predispose the development of atherosclerosis in the section proximal to the bridge.

Latar Belakang: Kecemasan pada kehamilan memiliki dampak yang buruk bagi ibu dan janin jika terjadi terus menerus, seperti spontaneous abortion, preeklamsia, bayi lahir prematur dan berat badan bayi lahir rendah. Diperlukan komunikasi dokter-pasien yang baik agar dapat membantu mengurangi kecemasan pada ibu hamil dan dapat meningkatkan pemahaman ibu tentang kehamilan. Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan komunikasi dokter-pasien terhadap tingkat kecemasan pada ibu hamil di poli rawat jalan Rumah Sakit Santo Vincentius Singkawang. Metode: Penelitian ini merupakan penelitian observasional analitik, dengan design cross sectional. Uji yang digunakan pada penelitian ini yaitu uji fisher’s exact. Populasi dalam penelitian ini yaitu ibu hamil di Rumah Sakit Santo Vincentius Singkawang, dengan jumlah 32 orang sampel yang telah memenuhi kriteria inklusi dan ekslusi. Instrument yang digunakan yaitu Generalized Anxiety Disorder-7 (GAD-7 versi Indonesia) dan Communication Assessment Tools (CAT). Penelitian ini juga sudah mendapatkan persetujuan Etik. Hasil: Hasil dari penelitian didapatkan 22 (68,8%) responden dengan kategori minimal anxiety, 5 (15,6%) responden dengan kategori mild anxiety, 3 (9,3%) responden dengan kategori moderate anxiety dan 2 (6,25%) responden dengan kategori severe anxiety. Selain itu, responden pada penelitian ini setelah melakukan konsultasi menyatakan kemampuan komunikasi dokter yang baik yaitu sebanyak 27 (84,4%) responden dan sebanyak 5 (15,6%) responden menyatakan kemampuan komunikasi buruk. Hasil uji fisher’s exact didapatkan hasil P= 0,293. Kesimpulan: Tidak terdapat hubungan antara komunikasi dokter-pasien dengan tingkat kecemasan ibu hamil di Poli Rawat Jalan Rumah Sakit Santo Vincentius Singkawang

Introduction: Hepatocellular carcinoma (HCC) remains a major cause of cancer-related mortality, and many patients present with intermediate or advanced disease. Transarterial chemoembolization (TACE) is an established treatment; however, its proangiogenic effects support the use of combination therapy. Combinations of TACE with immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) have shown a promising antitumor activity. The objective of this study was to describe post-treatment mRECIST response patterns of TACE alone, TACE plus lenvatinib and pembrolizumab, and TACE plus atezolizumab and bevacizumab for HCC. Methods: This multicentre retrospective, non-randomized pilot study included 25 consecutive patients with unresectable HCC treated with TACE alone (n = 10), TACE–lenvatinib–pembrolizumab (n = 7), or TACE–atezolizumab–bevacizumab (n = 8). The primary outcome was first post-treatment mRECIST response. ORR and DCR were calculated descriptively. Secondary outcomes included imaging interval, TACE exposure, repeat TACE, ALBI change, and OS, estimated using Kaplan–Meier methods. Results: Complete response, partial response, stable disease, and progressive disease occurred in 30.0%, 30.0%, 10.0%, and 30.0% after TACE alone, 14.3%, 28.6%, 57.1%, and 0% after TACE–lenvatinib–pembrolizumab, and 0%, 37.5%, 0%, and 62.5% after TACE–atezolizumab–bevacizumab. ORR/DCR were 60.0%/70.0%, 42.9%/100.0%, and 37.5%/37.5%, respectively. Median imaging intervals were 38.0, 25.0, and 20.0 months. ALBI-grade worsening occurred in 30.0%, 42.9%, and 37.5%; 1-year OS was 78.8%, 83.3%, and 50.0%, respectively. Conclusions: mRECIST response patterns were heterogeneous. Baseline liver-function imbalance, small groups, and non-randomized allocation preclude comparative efficacy inference. Larger prospective studies should standardize treatment sequencing, imaging, liver function assessment, safety monitoring, and survival evaluation.

BackgroundBrain metastases (BMs) most frequently originate from primary tumors of the lung and breast, and significantly impact cancer patient prognosis. Metastases can be detected synchronously along with the primary tumor or metachronously, following treatment of localized disease. The objective of this study was to identify key prognostic factors influencing survival in synchronous metastases (SM) and metachronous metastases (MM), focusing on metastatic duration, tumor volume response, and gamma knife radiosurgery. MethodsA retrospective cohort study was conducted involving 100 patients with brain metastases (48 synchronous, 52 metachronous). Age, gender, primary tumor, gamma knife status, metastasis location, peritumoral index group, volume reduction, metastatic duration, metastasis characteristics, and intensity pattern based on MRI. A Cox proportional hazards regression was used to analyze the data. Based on the Cox regression coefficients, a prognostic index was constructed. ResultsCalculated HR comprised MM (HR=0.49;95% CI :0.24–0.97], gamma knife treatment (HR = 0.15;95% CI: 0.07–0.29], and volume response (HR=0.40;95% CI: 0.16–0.99), all indicating a significantly reduced mortality risk. A prognostic index was calculated for all patients; those with scores ≤–1.513 were classified as low risk. Kaplan-Meier analysis showed that the low-risk group had a significantly longer mean survival period (75.52 months) compared to the high-risk group (31.43 months) (p<0.001). ConclusionMetachronous presentation, gamma knife therapy, and greater tumor volume reduction independently predict better survival. The developed prognostic index provides a clinically useful tool for personalized risk assessment and treatment planning in patients with brain metastases.

Latar belakang: Penyakit kardiovaskular merupakan penyebab utama kematian akibat penyakit tidak menular pada orang yang berusia lebih dari 35 tahun di seluruh dunia.VCAM-1 sebagai biomarker diagnostik potensial untuk memprediksi disfungsi endotel sebagai bagian dari proses kronis dari faktor risiko kardiovaskular menjadi penyakit kardiovaskular.⁸ Namun, belum ada laporan tentang hubungan antara VCAM-1 dengan faktor risiko kardiovaskular pada laki-laki Indonesia dengan penyakit kardiovaskular. Tujuan penelitian: Perbedaan kadar serum VCAM-1 pada faktor risiko kardiovaskular seperti status merokok, status diabetes, riwayat hipertensi, dan Body Mass Index (BMI) pasien pria dengan penyakit kardiovaskular. Metode: Penelitian cross-sectional retrospektif ini dilakukan dengan melibatkan pasien penyakit kardiovaskular. Semua pasien dengan rentang usia antara 30 hingga 65 tahun. Periode pendaftaran antara Januari 2021 dan September 2021 dengan 46 pasien yang memenuhi kriteria inklusi dan eksklusi. Karakteristik pasien dikumpulkan dari rekam medis pasien dengan informasi umur dan jenis kelamin. Status kesehatan meliputi faktor risiko kardiovaskular seperti Body Mass Index (BMI), diabetes, riwayat merokok, riwayat hipertensi, dan data laboratorium seperti VCAM-1. Perbandingan variabel BMI dan Diabetes dengan tiga kelompok atau lebih, uji One-way ANOVA untuk data parametrik untuk menemukan perbedaan dengan level VCAM-1. Perbedaan antara VCAM-1 dengan riwayat merokok dan hipertensi diperiksa menggunakan uji-t. Hasil: Semua BMI (p=0,693) dan diabetes (p=0,647) tidak memiliki signifikansi statistik dengan tingkat VCAM-1. Perbandingan riwayat merokok dengan kadar VCAM-1 bermakna secara statistik dengan nilai p < 0,001 namun tidak ada perbedaan bermakna secara statistik antara riwayat hipertensi dengan kadar VCAM-1. Kesimpulan: Terdapat perbedaan kadar VCAM-1 pada pasien dengan status merokok.