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All Journal Jurnal Kedokteran Brawijaya Indonesian Journal of Tropical and Infectious Disease Majalah Kesehatan FKUB Jurnal Respirasi (JR) Medica Hospitalia Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Malang Respiratory Journal
Listyoko, Aditya Sri
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Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Significance Level of Pleural Fluid Tissue Inhibitor Metalloproteinase-1 (TIMP-1) and Glucose Levels as Biomarkers of Malignant Pleural Effusion Michaela, Cleine; Putra, Ngakan Putu Parsama; Djajalaksana, Susanthy; Setijowati, Nanik; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.208-215

Abstract

Introduction: Distinguishing between malignant and non-malignant pleural effusions is often challenging due to overlapping biochemical profiles. Conventional diagnostic methods, including cytology and biopsy, are limited by their invasive nature, high costs, and potential complications. Emerging biomarkers, such as tissue inhibitor of metalloproteinase-1 (TIMP-1) and pleural fluid glucose levels, show promise as alternative diagnostic tools, but their clinical utility requires further validation. This study investigated the diagnostic value of TIMP-1 and pleural fluid glucose levels in differentiating malignant from non-malignant pleural effusions and explored their correlation in malignant cases. Methods: This cross-sectional analytical study included patients with exudative pleural effusion, categorized as malignant or non-malignant based on cytology and/or biopsy results. Biomarker levels of TIMP-1 and pleural fluid glucose were measured using enzyme-linked immunosorbent assay (ELISA) and biochemical analysis. Diagnostic thresholds for both biomarkers were determined using receiver operating characteristic (ROC) curve analysis. Results: Among 88 patients studied (33 malignant, 55 non-malignant), pleural fluid glucose levels were significantly lower in malignant cases (55.97 vs. 93.71 mg/dL; p=0.001), while TIMP-1 levels were notably higher (13.88 vs. 13.34 pg/mL; p<0.001). Tissue inhibitor of metalloproteinase-1 demonstrated superior diagnostic accuracy (86.5%) compared to glucose (70.6%) and the combined biomarker model (76.5%), with the sensitivity and specificity of 84.8% and 83.6%, respectively. Conclusion: Elevated TIMP-1 levels and reduced pleural fluid glucose levels are promising diagnostic biomarkers for malignant pleural effusion (MPE). Tissue inhibitor of metalloproteinase-1 exhibited the highest diagnostic accuracy, highlighting its potential as a non-invasive diagnostic tool in clinical practice.
Analysis of Urinary Midkine and Volatile Organic Compound (VOC) Levels Using a Breath Analyzer for Screening and Early Diagnosis of Lung Cancer Mafisah, Saidah; Setyawan, Ungky Agus; Tantular, Rezki; Permana, Deden; Djajalaksana, Susanthy; Wardoyo, Arinto Yudi Ponco; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.223-231

Abstract

Introduction: Lung cancer is the leading cause of cancer-related mortality worldwide. Midkine, a heparin-binding growth factor, promotes proliferation, angiogenesis, and metastasis. Volatile organic compounds (VOCs) reflect cellular and molecular changes, aiding in cancer diagnosis. This study explored urinary midkine and VOC profiles as biomarkers for lung cancer screening and early diagnosis. Methods: A case-control, cross-sectional study was conducted on 20 controls (family members of lung cancer patients) and 20 lung cancer patients who had not received therapy. Volatile organic compounds breath analysis and urinary midkine measurements were performed. Volatile organic compounds, including total volatile organic compounds (TVOCs), ethanol (C2H5OH), formaldehyde (CH2O), toluene (C7H8), acetone (C3H6O), hexane (C6H14), and methane (CH4), were collected from exhaled breath using Tedlar bags and measured with a µβreath analyzer. Meanwhile, urinary midkine levels were determined using the Enzyme-Linked ImmunoSorbent Assay (ELISA) method. Statistical analyses included an independent t-test, Mann-Whitney U test, Spearman correlation, and diagnostic testing with receiver operating characteristic (ROC) analysis. Results: Urinary midkine levels were higher in lung cancer patients than in controls (330.56±120.50 vs. 282.18±146.28 pg/mL), although not significant (p>0.05). The independent t-test revealed that ethanol levels were significantly elevated in lung cancer patients (p < 0.001), whereas methane levels were not (p > 0.50). Receiver operating characteristic analysis demonstrated sensitivity and specificity: urinary midkine (60%, 60%), ethanol (75%, 75%), and methane (45%, 45%). Conclusion: Ethanol VOC appears to be a promising non-invasive biomarker for the early detection of lung cancer, whereas elevated urinary midkine levels did not demonstrate significant diagnostic value.
Risk Analysis of Obstructive Sleep Apnea and Mental Disorders with Self-Reporting Questionnaire (SRQ-20) in Hospitalized COVID-19 Patients Falyani, Silvy Amalia; Pratiwi, Suryanti Dwi; Sugiri, Yani Jane Rosihaningsih; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.07

Abstract

Introduction: Obstructive Sleep Apnea (OSA) is closely related to diseases such as hypertension, diabetes, cardiovascular disease, and obesity. Evaluation of sleep disorders and mental health in COVID-19 patients who are hospitalized has not been widely studied. The purpose of this study was to analyze the risk of OSA with STOP-Bang and mental disorders with the Self-Reporting Questionnaire (SRQ-20) in hospitalized COVID-19 patients at RSUD dr. Saiful Anwar Malang. Case: Thirty five respondents with confirmed mild and moderate COVID-19 criteria randomly selected and agreed to give informed consent were given the STOP-Bang and SRQ-20 questionnaires, then the score was associated with the oxygenation ratio through blood gas levels. The research was conducted by cross sectional and statistical test using Chi Square and Mann Whitney test with p<0.05. Thirty five respondents were divided into two groups, 17 people (48%) with mild criteria and 18 people (52%) with severe criteria. The severity of COVID-19 had low effect on the risk of OSA (p=0.581) and mental disorders (p=0.191). The risk of mental disorders through SRQ-20 scoring had low effect on the severity of COVID-19 (p=0.229) and on the oxygenation ratio (p=0.068). Conclusion: The severity of COVID-19 and oxygenation ratio had low effect to the risk of OSA and mental disorders through the STOP-Bang and SRQ-20 scores in hospitalized COVID-19 patients at dr. Saiful Anwar Malang.
The Sleep Disorders And Depression Symptoms Among Hospitalized COVID-19 Patients Febriawati, Juwita; Astuti, Triwahju; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.06

Abstract

Introduction: Sleep disorders are found to be associated with hypertension, diabetes, cardiovascular disease and obesity, and can affect quality of life. Evaluation of sleep disorders and risk of depression in hospitalized COVID-19 patients have not been widely studied. The purpose of this study was to identify, evaluate, and analyze of sleep disorders and depression symptoms in hospitalized COVID-19 patients according to their severity and PaO2/FiO2 ratio. Case Report: A total of 35 patients with mild and moderate COVID-19 were given a questionnaire consisting of Epworth Sleepiness Scale (ESS) and Beck Depression Inventory (BDI), which was then analyzed together with the patient's blood gas analysis. Categorical data was compared using Chi Square Test, while the relationship between the continuous variables were measured with Pearson correlation test. A two-sided p value < 0.05 was considered statistically significant. About 42,85% and 62,9% COVID-19 patients were found to have sleep disorders and depression symptoms respectively. There were no significant differences between sleep disorders and the severity of COVID-19 (P=0.118) as well as PaO2/FiO2 ratio (P=0.411). Similarly, depression symptoms was not significantly different according to the severity of COVID-19 and PaO2/FiO2 ratio obtained with P=0.083 and P=0.061 respectively. Correlation test showed no significant correlation between sleep disorders and severity as well as PaO2/FiO2 ratio with r=0,274(p=0,111) and r=0,041(p=0,814) respectively. Likewise, negative correlation was found between depression symptoms and severity of COVID-19 (r=0,218;p=0,258)  as well as PaO2/FiO2 ratio (r=0,078, p=0,057). Conclusion:  In hospitalized COVID-19 patients, sleep disorders and depression were found, but there was no significant differences and correlation between sleep disorders and depression symptoms with the severity of COVID-19 and PaO2/FiO2 ratio.
D-Dimer and Brixia Score to Mortality in COVID-19 Patients Falyani, Silvy Amalia; Pratiwi, Suryanti Dwi; Setyawan, Ungky Agus; Erawati, Dini Rachma; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.99-106

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious severe and acute respiratory syndrome caused by the SARS-CoV-2 virus. A variety of factors can increase a patient's risk of death, including coagulopathy characterized by increased D-dimer levels. Brixia scores could be one of the determinants of COVID-19 severity, as assessed by chest radiographs. This study aimed to analyze chest radiographic severity based on the Brixia score at the degree of coagulation based on D-dimer in mortality of COVID-19 patients who were hospitalized. Methods: This cohort retrospective study was conducted at Dr. Saiful Anwar General Hospital, Malang, using an observational cross-sectional design. The study included 300 medical records of COVID-19 patients who passed away while hospitalized. The data were analyzed using the Wilcoxon test, and the results were also tested for Spearman correlation to determine the relationship between variables. Results: Significance results of median D-dimer were found by age and severity of COVID-19 (p-values 0.015 and 0.002), and median Brixia scores by age, gender, severity of COVID-19, and length of treatment (p-values 0.001, 0.001, 0.001, and 0.005). The results were also compared with normal values, which were significant (p = 0.000). Spearman correlation test results between the final D-dimer and the initial Brixia score (p = 0.005). Conclusion: The research results display a retrospective study of the correlation between D-dimer and Brixia score values "‹"‹and outcomes in COVID-19 patients. Higher D-dimer values"‹ "‹and Brixia scores on admission were shown to be associated with mortality.
Effects of Upper Arm and Breathing Exercise on Interleukin-6 in COVID-19 Patients Tarigan, Amira Permatasari; Listyoko, Aditya Sri; Pandia, Pandiaman; Pradana, Andika; Eyanoer, Putri Chairani; Sinaga, Sudirman Parningotan; Vera, Yeni; Firdaus, Ruby; Ramadhani, Adini Arifah
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.36-41

Abstract

Introduction: COVID-19 disease has become a comprehensive world issue and has been declared a significant threat to global health. Interleukin-6 (IL-6) is an important inflammatory marker and one of the triggers of the cytokine storm in COVID-19, where increased levels can be an independent predictor of COVID-19 mortality. This study aimed to observe the effect of upper arm and breathing exercises on IL-6 levels in severe COVID-19 patients. Methods: The study design was quasi-experimental, with blood tests conducted before and after the examination. A total of 20 patients with confirmed COVID-19 were involved, divided into intervention and control groups. Results: Blood tests to determine baseline IL-6 levels were performed in all patients. Patients from the intervention group were given upper arm and breathing exercises for ten days, twice a day, via video tutorials on mobile phones, while patients from the control group did not receive any exercises. Patients from the intervention group obtained mean pre- and post-exercise IL-6 levels of 42.38 ± 48.48 and 16.78 ± 18.29, respectively (p = 0.005). Conclusion: Upper arm and breathing exercises showed significant changes in IL-6 levels in severe COVID-19 patients.
Idiopathic Massive Bilateral Chylothorax : A Case Report Ananda, Ilham Revan; Listyoko, Aditya Sri; Putra, Ngakan Putu Parsama; Aslam, Achmad Bayhaqi Nasir
Malang Respiratory Journal Vol. 5 No. 2 (2023): September Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.02.03

Abstract

Abstract Introduction : Chylothorax is an uncommon medical condition caused by the accumulation of chylous fluid in the pleural space. Chylothorax has no predilection for sex or age. The prevalence after various cardiothoracic surgeries is 0.2% to 1%. Mortality and morbidity rates are around 10%. Respiratory distress may occur due to compression of the lung by the accumulated fluid. Management and approaches to treating the condition require multidisciplinary therapy, starting from non- pharmacological, pharmacological, to interventional management. Case Report : A 57-year-old Man patient was referred to the emergency room with chief complaint of shortness of breath. Reduced breathing sound on both lung fields. No previous history of cancer or thoracic surgery were found. X-ray examination had found bilateral pleural effusion. Thoracocentesis and pleural fluid analysis was performed with total of 6800 cc serosanguinous, whitish fluid was extracted from both of the lung. The patient was diagnosed with chylothorax. Lymphangiography and embolization was performed on the leak on left thoracic duct (T10) from right lymph node. Antibiotic was also given to treat the community acquired pneumonia that could be one of the possible etiology on this patient. Dietary modification with low fat diet and Ocreotide was also given to this patient as one of the treatment modalities. Discussion : The diagnosis of Chylothorax on this patient was established based on pleural fluid analysis and evidenced by lymphangiography examination by the presence of a leak in the thoracic lymphatic duct. Various modalities to diagnose this condition have been carried out with inconclusive results. Non-pharmacological, pharmacological and radiological interventions with embolization through lymphangiography are proven to be able to stop leaks and reduce symptoms in this patient. Conclusion : Chyle leak to the pleural space may compress the lung and cause respiratory distress. Combinaton of thoracocentesis, embolization of the leakage, dietary intake modification and administration of ocreotide may help prevent further chylous fluid accumulation. Keywords : chylothorax, embolization, lymphangiography, thoracocentesis.
aO2, SaO2, dan Rasio PaO2/FiO2 Sebagai Prediktor Derajat Keparahan Pasien COVID-19 Rawat Inap Putra, Ngakan Putu Parsama; Listyoko, Aditya Sri; Christanto, Anthony
Majalah Kedokteran Indonesia Vol 70 No 12 (2020): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, V
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.70.12-2020-326

Abstract

Introduction: Currently COVID-19 continues to show an increase in prevalence and mortality. Fever, dry cough, fatique and progression to dyspnea even respiratory failure and ARDS are the symptoms of COVID-19. “Happy hypoxia” is an indication that certain patients do not express breathlessness but have impaired oxygenation. It is important to determine the degree of oxygenation an all COVID-19 patients that will predict the severity of the disease and provide an outline of further management plans.Objective: This study aimed to describe the parameters of blood gas analysis in hospitalized patients and analyze its correlation with degree of severity of the diseaseMethods: We conducted observational analysis, cross sectional, single-center study including 71 laboratory-confirmed patients in Dr. Saiful Anwar General Hospital, Malang, Indonesia from April-Juni 2020. Statistical analysis was performed to determine the determine the relation of blood gas analysis with disease severity. Result: Subjects were divided to 25 patients (35,21%) in the mild-moderate group and 46 patients (64,79%) in severe group. Analysis of demographic and clinical characteristic showed that age, history of smoking, dyspnea and oxygen delivery were associated with disease severity (p less than 0,005). Statistical analysis of blood gas analysis showed associated degree of oxygenation with disease severity which is assessed by PaO2, SaO2 BGA, PaO2/FiO2 and original PaO2 (p less than 0,005). Conclusion: In our cross sectional study we found that degree of oxygenation was associated with disease severity in hospitalized COVID-19 patients.
Risk Factors Analysis for Rapid In-Hospital Mortality among Covid-19 Patients in a Tertiary Care Hospital in Indonesia Febriawati, Juwita; Putra, Ngakan Putu Parsama; Listyoko, Aditya Sri; Djajalaksana, Susanthy
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.15

Abstract

Systemic inflammation plays an important role in pathogenesis of Covid-19, especially in development of ARDS which is characterized by decrease of PaO2/FiO2 ratio. CRP and procalcitonin are inflammatory markers that are closely associated with severity and mortality of Covid-19. Although several studies have addressed benefit of CRP and procalcitonin as markers on Covid-19 severity, the benefit of these inflammatory markers for in-hospital mortality remain inadequately understood. The aim of this study was to analyze PaO2/FiO2 ratio,comorbidity,CRP,and procalcitonin as risk factors that affect time of in-hospital mortality Covid-19 patient. This was a retrospective observational cohort study of 250 Covid-19 patients who died during hospitalization and data was retrieved from medical record. Laboratory data was collected from three different times, including at time of admission,third day of hospital care,and before patient’s death. Data were analyzed using Chi square test,Mann Whitney test,Wilcoxon test, Friedman test, and binary logistic regresion. There were significant differences between CRP and procalcitonin at admission and time of in-hospital mortality (p<0.001; p=0.007). Binary logistic regression  analysis revealed significant relationship between CRP and time of in-hospital mortality with p=0.007. ROC curve showed optimal threshold of 11.75mg/L with sensitivity 72.3%; specificity 59.6%, RR 3.24(95% CI: 1.84-5.70). Significant changes were observed regarding PaO2/FiO2 ratio,CRP,and procalcitonin at admission as compared to before patient’s death with p<0.001;p=0.017;p<0.001 respectively. This study showed significant decrease of PaO2/FiO2 ratio, elevated CRP and procalcitonin at admission as compared to before patient’s death. The increase of CRP could serve as predictor for time of in-hospital mortality for Covid-19 patient.
Co-Authors Ananda, Ilham Revan Andika Pradana Arinto Yudi Ponco Wardoyo Aslam, Achmad Bayhaqi Nasir Christanto, Anthony Djajalaksana, Susanthy Edwin Widodo Erawati, Dini Rachma Falyani, Silvy Amalia Febriawati, Juwita Firdaus, Ruby Harun Al Rasyid Kevin Wahyudy Prasetyo Mafisah, Saidah Michaela, Cleine Nanik Setijowati Pandia, Pandiaman Parsama Putra , Ngakan Putu Permana, Deden Pratiwi, Suryanti Dwi Putra, Ngakan Putu Parsama Putri Chairani Eyanoer, Putri Chairani Ramadhan, Fitratul Ramadhani, Adini Arifah Rozi, Achmad Syamsufandi Safrina Dewi Ratnaningrum, Safrina Dewi Santosa, Andrew Santoso, Agus Andreas Setyawan, Ungky Agus Sinaga, Sudirman Parningotan Sugiri, Yani Jane Sugiri, Yani Jane Rosihaningsih Tantular, Rezki Tarigan, Amira Permatasari Tjahyadi, Rizal Muldani triandani, Ni Komang Revina Triwahju Astuti Vera, Yeni