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Hubungan Antara Status Kemoterapi , Jumlah Netrofil dengan IgM dan IgG Antimannan pada Pasien Kanker Paru yang Mengalami Kolonisasi Candida spp Chozin, Iin Noor; Setyawan, Ungky; Rakhma, Sastia
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Latar Belakang: Diagnosis Candida spp yang menyebabkan kandidiasis pada pasien kanker paru masih sulit. Kondisi ini berhubungan dengan status immunocompromise pada pasien. Salah satu biomarker yang dapat membantu diagnosis adalah IgM dan IgG antimannan. Tujuan penelitian ini untuk menganalisis hubungan antara status kemoterapi, jumlah neutrophil absolut dengan IgM dan IgG antimannan. Metode: Design penelitian correlative analytic cross-sectional mengikutsertakan 37 pasien di ruang rawat inap RSUD Dr. Saiful Anwar Malang. Kriteria inklusi meliputi pasien berusia >18 tahun dengan kanker paru yang tegak secara patologi anatomi kanker paru bukan sel kecil maupun kanker paru sel kecil, kultur sputumnya tumbuh Candida spp dengan atau tanpa spesies jamur ataupun koloni bakteri. Kriteria eksklusi penelitian ini meliputi pasien kanker paru dengan infeksi HIV dan penyakit autoimun. Dari 37 pasien ada yang sudah menerima kemoterapi dan belum kemoterapi. Dilakukan pemeriksaan jumlah netrofil absolut dan antibodi antimannan IgM dan IgG. Data status kemoterapi, jumlah netrofil absolut dianalisis hubungannya dengan antibodi IgM dan IgG antimannan. Hasil: Hasil penelitian ini menunjukkan tidak ada korelasi antara status kemoterapi dengan kepositifan IgM antimannan (p=0.585;r=0.089) maupun IgG antimannan (p=0.124;r=0.245). Terdapat hubungan yang signifikan dengan arah positif dengan kekuatan cukup antara jumlah neutrophil absolut dengan antibodi IgM antimannan (p=0,042; r=0,362), namun tidak terdapat hubungan antara jumlah neutrophil absolut dengan antibodi IgG antimannan (p=0,094; r=0,277). Kesimpulan: Tidak terdapat hubungan antara status kemoterapi dengan IgM antimannan maupun IgG antimannan. Terdapat hubungan signifikan dengan kekuatan cukup, arah positif antara IgM antimannan dengan jumlah netrofil absolut, tetapi tidak ada hubungannya dengan IgG antimannan.

Hubungan Rasio Neutrofil Limfosit (RNL) d engan Status Merokok Pada Kanker Paru Indah Sari, Fitri; Setyawan, Ungky; Destyana, Dita
Jurnal Klinik dan Riset Kesehatan Vol 3 No 1 (2023): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.1.2

Pendahuluan: Angka kematian yang tinggi dipengaruhi beberapa faktor risiko salah satunya rokok yang saat ini menjadi faktor risiko utama penyebab kanker paru. RNL dari darah lengkap perifer dapat menjadi bukti inflamasi sistemik dan indeks prognostik kanker. Penelitian terbaru menunjukkan bahwa RNL memiliki peran penting dalam respon imun terhadap kanker paru. Tujuan: Tujuan penelitian ini adalah untuk mengetahui karakteristik pasien kanker paru berdasarkan usia, jenis kelamin, status merokok dan RNL di RSSA Malang dan hubungan antara RNL dengan status merokok pasien kanker paru di RSSA Malang. Metode: Metode penelitian ini merupakan penelitian observasional analitik dengan menggunakan pendekatan desain penelitian cross-sectional. Metode penelitian ini merupakan penelitian observasional analitik dengan menggunakan pendekatan desain penelitian cross-sectional. Populasi penelitian ini adalah semua pasien yang terkonfirmasi kanker paru yang dirawat di RSUD Dr. Saiful Anwar Kota Malang pada bulan Januari 2021 hingga bulan Maret 2022. Data sampel merupakan data sekunder yang diambil dari rekam medis 40 pasien kanker paru di RSSA Malang. . Data yang diperoleh diinput ke excel. Setelah itu, dianalisis menggunakan SPSS. Data yang sudah diinput ke SPSS, dilakukan analisis diantaranya uji normalitas data (Saphirwo-Wilk), uji beda untuk mengetahui apakah ada nilai RNL yang signifikan pada pasien kanker digunakan Uji Independent T-Test, Uji Korelasi untuk mengetahui apakah terdapat hubungan antara RNL dengan status pasien kanker paru dengan ketentusn Uji Pearson apabila distribusi normal dan Uji Spearman apabila distribusi tidak normal. Hasil: Hasil penelitian menunjukkan karakteristik subyek didominasi usia <60 tahun dimana status perokok lebih banyak terdata pada penelitian ini dengan jumlah 22 dengan jenis kelamin laki-laki lebih mendominasi dibandingkan perempuan dengan jumlah 24 dan lebih terdata sebagai perokok. Pada penelitian ini nilai RNL >3.53 lebih banyak ditemukan pada pasien kanker paru. Mean pada perokok memiliki nilai RNL yang lebih tinggi yaitu 4.821±3.88 sedangkan pada bukan perokok memiliki nilai 4.253±3.73. Kesimpulan: Tidak terdapat perbedaan dan hubungan signifikan nilai RNL pada perokok dan bukan perokok.

Hubungan Antara Status Kemoterapi , Jumlah Netrofil dengan IgM dan IgG Antimannan pada Pasien Kanker Paru yang Mengalami Kolonisasi Candida spp Chozin, Iin Noor; Setyawan, Ungky; Rakhma, Sastia
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.01.2.3

Background: The diagnosis Candidiasis spp in patients with lung Cancer is difficult. It is related to immunocompromised status. Antimannan IgM and IgG biomarkers are used to diagnose candidiasis. The aim of this study is to determine the correlation between chemotherapy status, absolute neutrophyl count to antimannan IgM and IgG. Methods: The study design was a cross-sectional correlative analytic which included 37 patients in inpatient ward of Dr. Saiful Anwar Hospital Malang. The inclusion criteria patients aged >18 years with lung cancer who had established anatomical pathology, both non-small cell lung cancer and small cell lung cancer, and on sputum culture examination Candida spp grew with or without the growth of colonies of fungal species nor bacterial colonies. Exclusion criteria included lung cancer patients with HIV infection and autoimmune disease. Of the 37 patients who had received chemotherapy and had not received chemotherapy. The absolute neutrophil count and IgM and IgG antimannan were examined. Data chemotherapy status, absolute neutrophil count were analyzed in relation to IgM and IgG antimannan antibodies. Results: This study showed that there were not correlation between chemotherapy status with antimannan IgM (p=0.585; r=0.089) nor IgG (p=0.124; r=0.245). However, there was a positive, moderate correlation between absolute neutrophil count and antimannan IgM (p=0,042; r=0,362), but there is no correlation between absolute neutrophil count and antimannan IgG (p=0,094;r=0,277). Conclusion: There is positive moderate correlation between IgM antimannan with absolute neutropil count but no correlation with IgG antimannan. There is no correlation between IgM and IgG antimannan with chemotherapy status.

Hubungan Rasio Neutrofil Limfosit (RNL) d engan Status Merokok Pada Kanker Paru Indah Sari, Fitri; Setyawan, Ungky; Destyana, Dita
Jurnal Klinik dan Riset Kesehatan Vol 3 No 1 (2023): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.1.2

Background: The high mortality rate is influenced by several risk factors, one of which is smoking which is currently the main risk factor for lung cancer. NLR and from peripheral whole blood can be evidence of systemic inflammation and cancer prognostic index. Aim: The purpose of this study was to determine the characteristics of lung cancer patients based on age, sex, smoking status and NLR in RSSA Malang and the relationship between RNL and smoking status of lung cancer patients in RSSA Malang Methods: This research method is an analytic observational study using a cross-sectional research design approach. The population of this study were all patients who were diagnosed lung cancer who were treated at RSUD Dr. Saiful Anwar Malang City from January 2021 to March 2022. The sample data is secondary data taken from the medical records of 40 lung cancer patients at RSSA Malang. Results: The results showed that the characteristics of the subjects were dominated by age <60 years where the smoking status was more recorded in this study with a total of 22 with male sex being more dominant than women with a number of 24 and more recorded as smokers. In this study, NLR values >3.53 were more commonly found in lung cancer patients. The mean in smokers has a higher NLR value of 4.821 ± 3.88 while in non-smokers it has a value of 4.253 ± 3.73. Conclusion: There is no significant difference and relationship between NLR values in smokers and non-smokers.

Management of Thoracic Empyema with Pleuroscopy in Lung Cancer Patient Putra, Christian Surya Eka; Setyawan, Ungky; Putra, Ngakan
Malang Respiratory Journal Vol. 4 No. 1 (2022): Vol. 4 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.01.3

Background: Thoracic empyema is a serious complication related to death at young age and old age. The most common cause of thoracic empyema is parapneumonic effusion, and lung cancer is a rare cause of empyema. Pleuroscopy as an invasive procedure is often indicated as a second option for therapeutic purposes after chest tube insertionCase: We reported one case at Dr. Saiful Anwar, a man, 61 years old, was diagnosed with lung cancer with recurrent pleural effusions. Then after receiving chemotherapy, the patient was hospitalized again because of his worsening condition. From the lateral chest X-ray, a complex hydropneumothorax was obtained. Thoracentesis procedure revealed a greenish-yellow cloudy pleural fluid. The patient underwent pleuroscopy to evaluate the cause of empyema and drainage of pus. Necrotic tissue and pleural surface with nodules were found on pleuroscopy. The results of the anatomical pathology examination from pleural biopsy showed suppurative inflammation with several atypical cellsConclusion: Management of empyema must be carried out as soon as possible and appropriately. Pleuroscopy can be performed as a diagnostic and therapeutic measure in cases of thoracic empyema caused by lung cancer

A Rare Case of Chylothorax Manifestation of Gorham’s Disease, Lymphangioma and Tuberculosis Agil Dananjaya; Setyawan, Ungky; Putra, Ngakan; Erawati, Dini; Isharanto, Artono; Norahmawati, Eviana; Irmansyah, Istan
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.1

Background: Chylothorax is a rare condition caused by accumulation of chyle in the pleural cavity (2-3%). More rare causes are Gorham's disease and tuberculosis Case: A 31-year-old male complained of swelling left arm and shortness of breath with recurrent pleural effusion. Pleural fluid analysis showed chylous. Bone survey showed osteolytic lesions of multiple bones as Gorham's disease. Thoracic CT showed left lung mass, atelectasis, massive fluidothorax, ipsilateral supraclavicular lymphadenopathy, destructive left scapula. Needleaspiration of left humerus revealed lymphangioma. Expert Mtb-Rif examination revealed Mtb detected. We assessed Gorham'sdisease, lymphangioma and lung tuberculosis with complication recurrent chylothorax and was treated anti-tuberculosis, anti-osteolytic and thorax catheter insertion. Conclusion: Difficult and rare case of chylothorax in one patient with Gorham’s disease and tuberculosis, is a poor prognosis. Keywords: Chylothorax, Gorham's Disease, Tuberculosis

Exogenous Lipoid Pneumonia Effendi, Tiar Oktavian; Setyawan, Ungky; Putra, Ngakan; Erawati, Dini
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.3

Background : Lipoid pneumonia is a rare disease and usually reported as sporadic cases. Exogenous lipoid pneumonia is a more common form of lipoid pneumonia. Untypical characteristics makes incidence rate of this cases are often imprecise. The diagnosis is made from a history of lipid containing material aspiration, radiologic imaging, and histopathological examination. There is no treatment of choice because diagnosis of this cases are rarely made. Case Report : We report one case at Dr. Saiful Anwar hospital, a 35 years old man with accidental kerosene ingestion and aspiration. Based on examination of the patient, laboratory results, radiological imaging, and BAL fluid analysis and cytology, diagnosis of exogenous lipoid pneumonia was made. Our treatment of choice was combination of antibiotic, corticosteroid and BAL to manage this patient. After 2 weeks of treatment, there were improvements on clinical and radiological imaging. Conclusion: Exogenous lipoid pneumonia is a rare disease. Using antibiotic, corticosteroid, and BAL through bronchoscopy can be a therapeutic option that provides clinical and radiological improvement. Key words : Lipoid Pneumonia, Exogenous Lipoid Pneumonia, Treatment of Lipoid Pneumonia

A Thymoma (Case Report): Importance of Comorbidity, Lifestyle, and Thymoma Size in Treatment Success Suryaman, Rachmat; Djajalaksana, Susanthy; Setyawan, Ungky; Wardhana, Koernia; Erawati, Dini; Yudhanto, Hendy
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.4

Thymoma is a rare malignancy with an incidence of 0,15 case per 100.000 population and is the most commonly diagnosed anterior mediastinal malignancy. With 12,5% 15-year survival rate, and is often accompanied by autoimmune disease such as myasthenia gravis, pure red blood cell aplasia, and hypogammaglobulinemia, better understanding of factors affecting prognosis is needed to improve patient quality of life and survival.

Severe Abdominal Pain Due To Gastrointestinal Obstruction in Patient With Lung Adenosquamous Metastases in Colon Zata Dini; Pratiwi, Suryanti; Setyawan, Ungky; Budianto, Aries; Yudhanto, Hendy; Erawati, Dini
Malang Respiratory Journal Vol. 5 No. 1 (2023): Volume 5 No 1, March 2023
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.01.5

Background: Lung cancer is the most common cause of cancer-related death globally. Moreover, metastatic cancer from the lungs frequently occurs and is commonly identified at the first diagnosis. The primary cancer must be identified in order to establish the most effective treatment. However, colonic metastases are rare with incidence of 0,1%. Aim: This report describes an unusual case of colonic metastases from lung adenocarcinoma. Methods: Patient (58-year-old male) was examined with Fiber Optic Bronchoscopy and core biopsy in the lungs, and the results were suspicious for squamous cells. The patient had severe abdominal pain and bloating for 1 week and had signs of gastrointestinal obstruction in his second visit. The result of urgent laparotomy was adenosquamous and the result of immunohistochemical examination was negative P40 and positive Napsin A in both lungs and colon. Results: The lung biopsy result indicated squamous cell and the ceccum showed adenosquamous. The immunohistochemical examination using P40 and Napsin A of both lung and ceccum specimens indicated that the lung was the primary source of metastases to the colon. Conclusion: The patient suffered from a squamous cell lung tumor and reported severe abdominal pain due to metastases to the colon with adenosquamous results.

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