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All Journal Respiratory Science
Prasenohadi, Prasenohadi
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Health Professions Medicine & Pharmacology

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Obesity Hypoventilation Syndrome (Pickwickian Syndrome): A Literature Review Ramadhan, Alfin Ridha; Betcy, Betcy; Aurora, Ruth Grace; Prasenohadi, Prasenohadi; Alatas, Mohamad Fahmi
Respiratory Science Vol. 5 No. 1 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i1.155

Abstract

Obesity hypoventilation syndrome (OHS), also known as Pickwickian syndrome, is a respiratory disorder characterized by reduced alveolar ventilation and elevated daytime carbon dioxide levels, primarily associated with obesity. If untreated, OHS can progress to pulmonary hypertension (PH) and ultimately heart failure. The exact prevalence of OHS in the general population remains unclear, but studies estimate it to range from 8% to 12.3%, increasing with obesity prevalence. This review discusses the diagnostic criteria for OHS, the utility of the STOP-Bang questionnaire in screening, and advances in understanding the pathophysiology and management of OHS, focusing on heart failure with preserved ejection fraction (HFpEF). Accurate diagnosis of OHS is critical and requires a thorough approach involving an extensive patient medical history and physical examination to differentiate OHS from obstructive sleep apnea (OSA). Key diagnostic tests include serum bicarbonate levels and arterial blood gas (ABG) analysis, to confirm the hypercapnia and identify the severity of hypoventilation. Given the rising prevalence of obesity worldwide and the serious complications associated with untreated OHS, early and accurate identification of OHS is essential, as it can prevent the progression to severe pulmonary hypertension (PH) and the subsequent development of heart failure (HF).
The Evolution of Transbronchial Lung Biopsy Guidance Alatas, Mohammad Fahmi; Bies, Asri Liqditta; Prasenohadi, Prasenohadi; Soehardiman, Dicky; Aniwdyaningsih, Wahju; Elhidsi, Mia; Desianti, Ginanjar Arum; Reisa, Tina; Rasmin, Menaldi
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.170

Abstract

Histological confirmation of lung lesions is necessary prior to determining further management. Imaging preparation is needed to find the biopsy site such as a computed tomography scan. Imaging helps to trace the position of lung lesions that are peripheral and not visualized by bronchoscope. However, along with the discovery of small lesions and peripheral location, two-dimensional imaging alone remains suboptimal. Therefore, to reach lung lesions peripherally would need to a guide through the bronchial. Subsequently, the method of guiding transbronchial biopsy evolved. Namely, real-time fluoroscopy, radial-probe endobronchial ultrasound, virtual bronchoscopy navigation and electromagnetic bronchoscopy navigation are guiding modalities with each of their advantages and disadvantages. Several biopsy modalities are used in combination to increase the accuracy of diagnosis. Careful analysis in planning and an understanding of the limitations and advantages of diagnostic modalities must be considered in deciding which method to choose.
Positivity Rates of Histology Results Based on Lesion Size and Bronchus Sign in Lung Cancer Navratilova, Melfia; Aniwidyaningsih, Wahju; Soehardiman, Dicky; Prasenohadi, Prasenohadi; Alatas, Muhamad Fahmi; Elhidsi, Mia; Desiyanti, Ginanjar Arum; Reisa, Tina; Martini, Ni Putu Laksmi Ananda
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.175

Abstract

Background: Lung cancer continues to be a major cause of cancer-related deaths globally. Bronchoscopy serves as a key diagnostic tool, allowing histological sampling through transbronchial biopsy (TBB). The bronchus sign, identified on pre-biopsy CT scans, is associated with improved diagnostic yield in TBB. Method: A retrospective study was conducted between October and December 2023 at Persahabatan Hospital, Jakarta, analyzing 88 patients suspected of lung cancer. Data collected comprised patient demographics, lesion size as determined by CT scans, and the presence or absence of the bronchus sign. Fisher’s exact test was applied for statistical analysis, with a predetermined significance level of P<0.05. Results: Positive histology results were identified in 38 cases (55.07%) for lesions ≥3 cm and 9 cases (47.39%) for <3 cm(P=0.607). In lesions ≥3 cm, the positivity rate was similar between those with the presence (55.81%) and absence (53.85%) of a bronchus sign (P>0.99). In lesions <3 cm, positivity was higher with a bronchus sign (60%) than without (25%) (P=0.55). Conclusion: The bronchus sign appears to increase TBB positivity, especially in peripheral lesions <3 cm. Lesion size also appears to influence TBB yield. However, the findings were not statistically significant, likely due to small sample size and missing CT data.
Co-Authors Alatas, Mohamad Fahmi Alatas, Mohammad Fahmi Alatas, Muhamad Fahmi Aniwdyaningsih, Wahju Aniwidyaningsih, Wahju Betcy, Betcy Bies, Asri Liqditta Desianti, Ginanjar Arum Desiyanti, Ginanjar Arum Elhidsi, Mia Martini, Ni Putu Laksmi Ananda Menaldi Rasmin Navratilova, Melfia Ramadhan, Alfin Ridha Reisa, Tina Ruth Grace Aurora Soehardiman, Dicky