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Concordance Level between Impulse Oscillometry and Spirometry for Pulmonary Function Test Hapsari, Brigitta Devi Anindita; Melita , Melita; Siregar, Sihsusetyaningtyas Tiominar; Apriningsih, Hendrastutik; Adhiputri, Artrien
Jurnal Respirologi Indonesia Vol 45 No 4 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i4.920

Abstract

Background: The most widely used lung function test, spirometry, requires constant coaching and more effort. An alternative modality of impulse oscillometry (IOS) was introduced, which is simpler than spirometry, requiring only basic tidal breathing and less cooperation, but with less stringent standards. Methods: This research was a diagnostic test research with medical records data of patients who underwent spirometry and oscillometry procedures within the same period. The study was conducted in Sebelas Maret University General Hospital from March to September 2024. Results: A total of 77% of examinations gave the same results, namely restriction in 32 people (30.8%) and obstruction in 48 people (46.2%). Meanwhile, as many as 23% of IOS examinations gave different results compared to spirometry examinations (discordance). Six normal results from spirometry showed the impression of obstruction in IOS. The agreement between the IOS examination and spirometry was moderately significant (P=0.0001). Conclusion: Impulse oscillometry is a useful adjunct to spirometry, which is still the gold standard, especially for patients who are incapable of performing forced maneuvers.
P/F Ratio is a Better Predictor for Non-Invasive Ventilation Failure and Length of Stay in Patients with Community-Acquired Pneumonia Hapsari, Brigitta Anindita Devi; Roxanne, Olivia Geraldine; Reviono, Reviono; Adhiputri, Artrien; Apriningsih, Hendrastutik; Rahayu, Nur Indah; Vagheggini, Guido
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.1.2024.42-49

Abstract

Introduction: Community-acquired pneumonia (CAP) can deteriorate into respiratory failure requiring immediate ventilatory intervention. This study compared the performance of the PaO2/FiO2 (P/F) ratio, the ratio of oxygen saturation (ROX) index, and the heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) score in predicting non-invasive ventilation (NIV) failure and length of hospital stay in patients diagnosed with CAP. Methods: This study was conducted at Universitas Sebelas Maret Hospital, Surakarta, from March to September 2023. All patients diagnosed with CAP who were eligible for NIV were recruited. Each patient's age, sex, comorbidities, vital signs, pneumonia severity index (PSI), blood urea, bilirubin, hematocrit, blood sodium, P/F ratio, ROX index, and HACOR score were measured within the first 24 hours of NIV. Subsequently, the correlations between these variables and NIV failure (intubation or mortality) and length of hospital stay were assessed. Results: The P/F ratio, ROX index, and HACOR score were not correlated with intubation or length of stay. The P/F ratio was correlated with mortality (p = 0.040), whereas the other scores were not. Higher body temperature was correlated with intubation (p = 0.032). PSI was correlated with both mortality (p = 0.033) and length of hospital stay (p = 0.009). Conclusion: The P/F ratio is superior to the ROX index and HACOR score in predicting mortality in patients with pneumonia-related respiratory failure treated with NIV. Since it is simple and accessible, measuring the P/F ratio within the first 24 hours of NIV is recommended to identify a patient's risk of NIV failure and apply appropriate monitoring.
Serum Matrix Metalloproteinase 9 Level, Blood Absolute Neutrophil Count in Correlation with Diffusion Capacity and Exercise Capacity of Stable Chronic Obstructive Pulmonary Disease Patients at Universitas Sebelas Maret Hospital Lestari, Anggraini Dwi; Apriningsih, Hendrastutik; Reviono, Reviono; Sutanto, Yusup Subagio; Setijadi, Ana Rima
Jurnal Respirologi Indonesia Vol 44 No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.400

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Exposure to cigarette smoke activates alveolar macrophages producing neutrophils and proteases such as MMP-9 and NE that damage the extracellular matrix triggering emphysema as well as spill over into the systemic circulation. This study aimed to determine the correlation of serum MMP-9 level and blood absolute neutrophil count with diffusion capacity and exercise capacity of stable COPD patients.Methods: A cross-sectional observational study was conducted in stable COPD patients visiting the pulmonary outpatient clinic of Universitas Sebelas Maret (UNS) Hospital in October 2022. Consecutive sampling was applied for sample collection. We assessed diffusion capacity and exercise capacity with the DLCO method and 6MWT, respectively. We examined serum MMP-9 level and blood absolute neutrophil count. All data were statistically analyzed with SPSS 22.0 and P<0.05 was considered significant.Results: Thirty stable COPD patients were included in the study comprising 19 males (63.3%), and 11 females (36.7%). With a mean age of 61.90±9.99. Serum MMP-9 level did not correlate with either diffusion capacity and blood absolute neutrophil count (P=0.898 and P=0.589, respectively). However, serum MMP-9 level had a significant correlation with exercise capacity (P=0.014). There was no correlation between blood absolute neutrophil count with diffusion capacity and exercise capacity (P=0.0281 and P=0.592, respectively). Diffusion capacity related to exercise capacity (P=0.001).Conclusion: Serum MMP-9 level is not related to diffusion capacity, but it is related to exercise capacity. Blood absolute neutrophil count is not related to diffusion capacity or exercise capacity. Serum MMP-9 level is not associated with blood absolute neutrophil count. Diffusion capacity is related to exercise capacity. 
Effects of Aerobic Exercise on The Six Minutes Walking Test and Quality of Life in EGFR Mutation Non-Small Cell Lung Cancer Patients Sibarani, Lia Priscilia; Setijadi, Ana Rima; Apriningsih, Hendrastutik; Harsini , Harsini; Raharjo, A. Farih; Sutanto, Yusup Subagio
Jurnal Respirologi Indonesia Vol 45 No 2 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i2.613

Abstract

Background: Lung cancer reduces lung function, muscle mass, and psychological well-being, which lowers exercise capacity and quality of life. Pulmonary rehabilitation, such as aerobic exercise, can improve exercise capacity and the quality of life (QoL) in lung cancer patients. This study aimed to investigate the influence of aerobic exercise on the six-minute walking test (6MWT) and the quality of life of lung cancer patients. Methods: A clinical trial with a quasi-experimental, pretest, and post-test design was conducted on stage ≥IVa adenocarcinoma lung cancer patients who were receiving outpatient targeted therapy at the pulmonary clinic of Dr. Moewardi General Hospital for ≥1 month starting from May 2023, until the required sample size was met. The 6MWT and Functional Assessment of Cancer Therapy-Lung (FACT-L) were measured at the baseline and eight weeks ±2 weeks after aerobic exercise by walking about 15-20 minutes and breathing exercises. Results: The study included fourteen patients in the control group and fifteen patients in the aerobic group. The mean difference of 6MWT between the control and the aerobic group was 38.33 m. Functional, lung cancer subscale (LCS), total, and TOI in FACT-L showed significant differences in the increment pre-test and post-test between the control and aerobic group (P<0.05), with significant differences in pre-test and post-test of most categories in both groups, except for social. Conclusion: Aerobic exercise, psychological support, and nutrition have significantly improved the 6MWT and quality of life in lung cancer patients.
Differences in White Blood Cells, Neutrophil-to-Lymphocyte Ratio, Tumor Necrosis Factor-α based on Procalcitonin Level in Community-Acquired Pneumonia Patients Sutanto, Yusup Subagio; Apriningsih, Hendrastutik; Syaikhu, Akhmad; Siregar, Sihsusetyaningtyas Tiominar
Jurnal Respirologi Indonesia Vol 44 No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.632

Abstract

Background: Community-acquired pneumonia (CAP) is a respiratory infectious disease caused by bacteria, viruses, or fungi. Procalcitonin (PCT) levels will rise, especially in bacterial infection. PCT examination in CAP can help to confirm the diagnosis and anticipate complications. CAP is diagnosed by symptoms, vital signs, laboratory tests, and radiographic investigations. Inflammatory biomarkers are required for predicting causative microorganisms, guiding antibiotic therapy, and determining severity. The purpose of this study is to compare NLR, WBC, and TNF-α levels in CAP patients dependent on PCT level.Methods: This was an analytical cross-sectional study involving 43 CAP patients admitted to Universitas Sebelas Maret (UNS) Hospital and Moewardi Regional General Hospital Surakarta between February and March 2023. Patients were separated into two groups based on PCT levels: those with levels ≤0.12 ng/mL and >0.12 ng/mL. All patients provided a blood sample for NLR, WBC, TNF-α, and PCT testing. The independent t-test and Mann-Whitney tests were performed for statistical analysis of two unpaired groups, and the Chi-square or Fisher exact test was utilized for ordinal categorical data. If the value of P<0.05, the result is statistically significant.Results: NLR and TNF-α levels were higher in the PCT group >0.12 ng/mL and statistically significant with a value of P=0.001. WBC levels in the PCT group >0.12 ng/mL were higher, but the difference was not statistically significant (P=0.096).Conclusion: The NLR value, WBC, and TNF-α levels were found to be higher in the group with PCT >0.12 ng/mL. 
Case Report: Pneumonia Provocate Thyroid Storm in Graves Disease Hermawati, Berty Denny; Prabowo, Nurhasan Agung; Putri, Desy Puspa; Myrtha, Risalina; Apriningsih, Hendrastutik
Smart Medical Journal Vol 6, No 1 (2023): April
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i1.68166

Abstract

Introduction: A thyroid crisis is an endocrine emergency involving many organ systems and can be fatal to the patient's survival. Although cases of thyroid crisis are rare, the mortality rate is significant which reaches 20–50%. The presence of comorbidities such as pneumonia infection increases the risk of death dramatically. Infection is a factor that can trigger thyroid crisis and exacerbate thyrotoxicosis. This condition of thyroid crisis most often occurs in people with hyperthyroidism caused by Graves' disease. We present the case of a patient with Graves' disease, aged 22 years, who developed a thyroid crisis due to community-acquired pneumonia infection. This study aims to provide a case report regarding the thyroid crisis due to pneumonia.Results: We carried out a physical and some appropriate supporting examinations to confirm the diagnosis. Wayne's index was 26, indicating hyperthyroidism. Assessment with Burch-Wartofsky obtained a score of 45, indicating suspicion of a thyroid storm. Then supportive care was provided to the patient. The community-acquired pneumonia as a triggering factor was treated with antibiotics. Thyrotoxicosis conditions were treated with antithyroid, beta-blocker, and glucocorticoid drugs. The patient's condition improved after treatment.Conclusion: It is crucial to detect and treat thyroid storm as quickly as possible since it has a high mortality rate. Wayne's score is useful for identifying hyperthyroidism based on clinical symptoms. The Burch-Wartofsky Point Scale scores are used to diagnose thyroid storms. Thyroid storm should be managed according to PERKENI (Perkumpulan Endokrinologi Indonesia) and ATA (American Thyroid Association) recommendations. This case serves as an example of how to make a proper diagnosis and treatment to prevent morbidity and death due to thyroid crisis.
A 21-Year-Old Woman with Suspecting Gitelman Syndrome Denny, Berty; Agung Prabowo, Nurhasan; Puspa Putri, Desy; Myrtha, Risalina; Apriningsih, Hendrastutik
Smart Medical Journal Vol 5, No 2 (2022): Smart Medical Journal
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v5i2.61735

Abstract

Introduction: Gitelman syndrome (GS), is a hereditary condition marked by a specific kidney function impairment. GS symptoms do not normally manifest until beyond the age of six years. We present a rare case of a 21-year-old woman with a background in generalized weakness muscle cramps with tetany, fever, and dyspnea.  The goal of this study is to give a case report of Gitelman syndrome suspicion.Result: Gitelman syndrome is identified through clinical indicators and lab testing, such as low potassium and magnesium levels in the blood, metabolic alkalosis, and low calcium levels in the urine. We do a variety of physical and laboratory tests to determine the disease and rule out other possibilities. Molecular proof is difficult to get due to a lack of resources and the high expense of genetic testing, which has become one of our case report's flaws. This patient was diagnosed as suspecting Gitelman syndrome and treated for electrolyte imbalances. The patients were given replacement therapy, which comprised intravenous potassium, sodium, and chloride therapy, as well as calcium therapy. In addition, we also provided some symptomatic therapy. She was discharged five days later in fine condition.Conclusion : This is one of the few reports of a 21-year-old lady being suspected of having Gitelman syndrome (GS). We conduct a battery of physical and laboratory tests to diagnose the disease and rule out other possibilities. We provide the appropriate therapies in accordance with the guidelines, and the outcomes are favorable.
The Correlation Between Hypocalcemia and Clinical Level of Covid-19 Patients at Sebelas Maret University Hospital Udroso, Anindya Cahyaningtyas Ardiyanti; Apriningsih, Hendrastutik; Raharjo, Ahmad Farih
Smart Medical Journal Vol 6, No 2 (2023): August
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i2.68856

Abstract

Introduction: Coronavirus Disease 2019 (Covid-19) can cause electrolyte imbalances, one of which is hypocalcemia. Hypocalcemia has been identified as a predictor of the severity of Covid-19. This research aimed to determine the correlation between hypocalcemia and the clinical degrees of Covid-19 patients at UNS Hospital.Method: This study used a cross-sectional design with a population of Covid-19 patients treated at the Covid-19 ward at UNS Hospital in 2020-2022. Samples were collected from medical records by purposive sampling technique that met the inclusion and exclusion criterias.Results: There were 90 cases of hypocalcemia in Covid-19 patients. Mild hypocalcemia (88.9%) was found more than severe hypocalcemia (11.1%). Hypocalcemia was more common in male sex (54.4%), aged 46-65 years (70%), and in moderate clinical degree (31.1%). The Kolmogorov-Smirnov statistical test results showed a significant correlation between hypocalcemia and the clinical degree of Covid-19 with p=0.009 (p<0.05). The Spearman statistical test results showed that there was a fairly strong and statistically significant correlation between hypocalcemia and the clinical degree of Covid-19 where r=0.310 and p=0.003 (p<0.05).Conclusion: There is a fairly strong and statistically significant unidirectional correlation between hypocalcemia and the clinical degree of Covid-19 patients.