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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

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.

The Agreement of Immunoglobulin Gamma Release Assay (IGRA)/ T-SPOT Tuberculosis and Tuberculin Skin Test to Detect Latent TB Infection in Diabetes Mellitus Patients Reviono, Reviono; Sutanto, Yusup Subagio; Harsini, Harsini; Saptawati, Leli; Marwoto, Marwoto; Suryawati, Betty; Redhono, Dhani; Sebayang, Pribadi M
Indonesian Journal of Medicine Vol. 6 No. 3 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: WHO identifies diabetes mellitus (DM) as a neglected risk factor for tuberculosis (TB). Currently, there is no gold standard test for latent TB infection (LTBI). Centers for Disease Control and Prevention (CDC) recommends using Tuberculin Skin Test (TST) and Immunoglobulin Gamma Release Assay (IGRA) to diagnose LTBI. TST is an LTBI classic diagnostic tool that has low sensitivity and specificity. But it is still preferred in diagnosing LTBI due to its lower price, and more health facilities can perform the examination compared to IGRA (T-SPOT.TB). The study aimed to measure the agreement of TST and T-SPOT.TB testing in detecting LBTI in DM and the correlation of HbA1c with TST and T-SPOT.TB.Subjects and Method: Subjects were DM patients who underwent TST and T-SPOT.TB testing. If the results of TST and T-SPOT.TB was positive, the test would be continued with Xpert MTB/RIF microbiological testing. TST used PPD RT23 2TU. T-SPOT.TB was performed toward peripheral blood mononuclear cells. The degree of agreement between TST and T-SPOT.TB testing was calculated using the Test of Agreement (Kappa Cohen). The degree of correlation between the two variables was calculated by using Pearson correlation.Results: The selected 30 study subjects with DM undergoing antidiabetic therapy showed 6 (20%) detected LTBI and 24 (80%) without LTBI using TST and T-SPOT.TB test. There was a substantial agreement level between TST and T-SPOT.TB testing in detecting LTBI among diabetes mellitus patients undergoing anti-diabetic therapy with kappa value= 0.62 (p<0.001). HbA1c increased T-SPOT (r= 0.07; p= 0.716) and TST (r= 0.11; p= 0.956).Conclusion: TST testing may substitute T-SPOT.TB to detect LTBI among diabetes patients undergoing antidiabetic therapy.Keywords: latent tuberculosis infection, diabetes mellitus, TST, Immunoglobulin Gamma Release Assay (IGRA), T-SPOT.TBCorrespondence: Reviono. Department of Pulmonology and Medical Respiratory, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Indonesia. Email: reviono@staff.uns.ac.id.Indonesian Journal of Medicine (2021), 06(03): 298-306https://doi.org/10.26911/theijmed.2021.06.03.07

Long Covid-19, Radiological Findings, and Its Management: A Systematic Review Soewondo, Widiastuti; Putro, Prasetyo Sarwono; Hermansah, Muhamad Lukman; Lestari, Lilik; Reviono, Reviono; Harsini, Harsini; Adhiputri, Artrien
Indonesian Journal of Medicine Vol. 6 No. 4 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2021.6.4.446

Background: COVID-19 is a disease caused by SARS-CoV-2 and has numerous clinical spectrums. Mild respiratory infection is the common clinical manifestation of COVID-19, and the less common is pneumonia accompanied by fever, cough, and breathing difficulty. Long COVID can be defined as prolonged signs and symptoms which cannot be explained for other reasons 4 weeks after being diagnosed with SARS-CoV-2. This study aimed to describe the cause of illness is confirmed or suspected COVID-19 patients, specifically on long COVID.Subjects and Method: We performed literature searches of the latest articles with Medline, CINAHL (EBSCO), Global Health (Ovid), WHO Global Research on COVID-19 database, LitCovid and Google Scholar databases published from 2019 to 2020. Two reviewers searched all articles independently (P and W, with 7 and 10 years of experience, respectively). We conducted a systematic review to provide recent evidence of symptoms and complications in long COVID. We followed PRISMA guidelines.Results: A total of 22 papers was identified and screened for eligibility from medical databases. There were 15 papers included in this review. Reason for the continuous symptoms covid an extent of organ destruction, continuous response of chronic inflammation or immunology reaction, non-specific effect of hospital admission, some critical disease, post ICU syndrome, complications from COVID-19 infection, morbidities and adverse effects of medications used. Common symptoms are fatigue, shortness of breath, cough, chest pain, palpitations, dizziness, arthralgia, myalgia and weakness, sleep problems, sharp pain, gastrointestinal problems, rash and hair loss, impaired balance and ataxia, neurologic problems such as dementia, concentration disorders and poor quality of life.Conclusion: The incidence of long-term manifestations of COVID-19 has been increasing and systemic clinical symptoms affect many organs and systems. This can be due to numerous reasons like post-ICU syndrome, post-viral fatigue syndrome, permanent organ deterioration or others. Correspondence: Widiastuti Soewondo. Department of Radiology, Dr. Moewardi General Hospital/ Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Indonesia. Email: widiastuti.sprad56@staff.uns.ac.idIndonesian Journal of Medicine (2021), 06(04): 387-392https://doi.org/10.26911/theijmed.2021.06.04.04

Effects of Hypnotherapy on Pain Scale, Interleukin-6 Levels, and Quality of Life in Lung Cancer Patients Who Experience Cancer Pain Widyasanti, Diana; Sutanto, Yusup Subagio; Septiawan, Debree; Aphridasari, Jatu; Reviono, Reviono
Jurnal Respirologi Indonesia Vol 45 No 3 (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.v45i3.624

Background: Pain is a common symptom in lung cancer patients and can affect their quality of life. Interleukin 6 (IL-6) plays a role in malignant cell proliferation and differentiation as well as the initiation and persistence of cancer pain. Hypnosis can reduce pain by reducing anxiety through relaxation and/or directly affecting neurophysiological activity that underlies the subjective experience of pain. This study aimed to evaluate hypnotherapy as a non-pharmacological method for managing cancer pain. Methods: Clinical trial of 30 subjects with quasi-experimental pre-test and post-test in treatment and control groups of lung cancer patients of NSCLC and SCLC stage III and IV who experienced cancer pain with pain scale ≥3 at RSUD Dr. Moewardi Surakarta in June to August 2023 with a consecutive sampling method. The treatment group received hypnotherapy intervention for 4 weeks. Subjects were assessed for pain scale, interleukin-6 levels, and FACT-L quality of life questionnaire. Results: A 4-week hypnotherapy intervention can significantly reduce the pain scale (P=0.0001) and improve the quality-of-life FACT-L (P=0.002) in lung cancer patients experiencing cancer pain. Hypnotherapy also significantly reduced IL-6 in the treatment group (P=0.008), but when compared with the control, the results were not significant (P=0.345). Conclusion: Hypnotherapy may reduce the pain scale and improve the quality of life of lung cancer patients who experience cancer pain, but does not significantly lower IL-6 levels.

The Effect of Magnesium Citrate on %FEV1, %PEFR, and Asthma Control Test Score in Patients with Controlled Asthma and Uncontrolled Asthma Atmojo, Anang Purwoko; Sutanto, Yusup Subagio; Adhiputri, Artrien; Reviono, Reviono; Setijadi, Ana Rima
Jurnal Respirologi Indonesia Vol 45 No 3 (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.v45i3.503

Background: Asthma is one of the most common non-communicable diseases in the world and affected an estimated 262 million people in 2019. Magnesium is one of the nutrients known to improve lung function in asthma by inhibiting the production of proinflammatory cytokines, exhibiting anti-inflammatory benefits, and having beneficial muscle-relaxing and bronchodilatation effects. Measurement of percent predicted forced expiratory volume in 1 second (%FEV1), percent predicted peak expiratory flow rate (%PEFR), and asthma control test (ACT) score is are indicator of lung function. Magnesium citrate may be used as an adjunct therapy in patients with controlled and uncontrolled asthma. Methods: Clinical trial research with quasi quasi-experimental method using a pre-test and post-test design. The study subjects were 34 controlled and uncontrolled asthma patients at the outpatient clinic of Universitas Sebelas Maret Hospital and dr. Soehadi Prijonegoro Hospital in February - March 2023, using consecutive sampling. The control group (n=17) received standard therapy, while the treatment group (n=17) received standard therapy plus 300 mg magnesium citrate for 42 days. Serum magnesium level, %FEV1, %PEFR, and ACT score were measured at enrollment and on the forty-third day of treatment. Results: There were significant differences between the treatment group compared to the control group in increasing %PEFR (P=0.001), increasing ACT score (P=0.011), and increasing %FEV1 (P=0.071). Conclusion: Administration of magnesium citrate to patients with controlled and uncontrolled asthma can increase levels of %PEFR, ACT score, and %FEV1.

Modal Sosial dan Partisipasi Masyarakat dalam Penemuan Penderita Tuberkulosis Reviono, Reviono; Sulaeman, Endang Sutisna; Murti, Bhisma
Kesmas Vol. 7, No. 11
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Tuberkulosis merupakan masalah kesehatan masyarakat yang utama di tingkat global, regional, nasional, maupun lokal. World Health Organization menggulirkan strategi directly observed treatment short course (DOTS) dan strategi stop tuberculosis partnership bertujuan untuk menjangkau semua penderita tuberkulosis. Kedua strategi tersebut masih belum mampu mencapai target case detection rate (CDR) secara konsisten. Penelitian ini bertujuan merumuskan model modal sosial dan partisipasi masyarakat dalam crude death rate. Sasaran penelitian adalah petugas tuberkulosis dan kader di 30 desa di Kabupaten Karanganyar, Jawa Tengah. Metode yang digunakan adalah survei dan studi kasus. Hasil penelitian survei menunjukkan, desa dengan modal sosial yang tinggi mempunyai kemungkinan untuk melampaui target CDR ≥ 70%, 9 kali lebih besar daripada desa dengan modal sosial rendah. Desa dengan partisipasi masyarakat tinggi mempunyai kemungkinan 7,5 kali lebih besar daripada desa dengan partisipasi masyarakat rendah. Hasil penelitian studi kasus menunjukkan, faktor-faktor modal sosial yang berhubungan dengan CDR terdiri dari dimensi kognitif meliputi kepercayaan dan merasa mempunyai program tuberkulosis. Dimensi relasional meliputi norma sosial, penanaman jasa pribadi, kerja sama, dan komunikasi. Dimensi struktural meliputi jejaring dan persatuan. Faktor-faktor partisipasi yang berhubungan dengan CDR meliputi identifikasi kebutuhan, menggerakan sumber daya program, dan kepemimpinan. Tuberculosis is an important public health problem of global, regional, national, and local levels. World health organization launched directly observed treatment short course (DOTS) and stop tuberculosis partnership strategies aiming to reach all tuberculosis patients. Both strategies have not been able to reach the case detection rate (CDR) target consistently. This research aimed to formulate a social capital and participation model in crude death rate. The target of research was the officers of tuberculosis programs and cadres in 30 villages in Karanganyar Regency, Central Java. The method used in this research was survey and case study. The result of survey research showed that the village with high social capital had 9 times probability of surpassing CDR target ≥ 70% than the one with low social capital and 7.5 times higher than the one with low public participation. The result of case study showed that the social capital factors relating to CDR consisted of cognitive dimension encompassing trust and sense of belonging to tuberculosis program. Relational dimension encompassed social norm, personal service implantation, cooperation, and communication. Structural dimension involved public network and association. The factors of participation relating to CDR included need identification, activating the program resource, and leadership.

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

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

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.

The Effect of Curcuma longa Extract on Interleukin 6, Procalcitonin, Microbial Count, and Histopathology of the Lungs in a Rat Model Infected with Streptococcus pneumoniae Prasetyo, Yudhi; Reviono, Reviono; Hikmayani, Nur Hafidha; Adhiputri, Artrien; Setijadi, Ana Rima
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.v45i2.460

Background: Streptococcus pneumoniae causes 95% of cases of community-acquired pneumonia (CAP). Interleukin 6, procalcitonin, microbial count, and lung histopathology can help in determining indicators of inflammatory processes and prognosis. Curcumin, which acts as an anti-inflammatory and anti-microbial, can be used as an adjunctive therapy in infectious diseases. Methods: This was a laboratory experimental study. A sample of 30 white rats (Rattus norvegicus) infected with Streptococcus pneumoniae was carried out in the experimental animal laboratory at the Faculty of Medicine, Universitas Sebelas Maret in November 2022 with incidental sampling. The control group received 1cc of aquadest, the first treatment group received 30 mg/200 g of curcuma longa extract, the second treatment group received 50 mg/200 g of Curcuma longa extract, the third treatment group received 30 mg/200 g of Curcuma longa extract and 30 mg/200 g of amoxicillin, and the fourth treatment group received 30 mg/200 g of amoxicillin. Interleukin 6 and procalcitonin were measured on the third and twelfth days after the rats were infected with Streptococcus pneumoniae. The microbial count and histopathology of the lungs were assessed after the twelfth day. Results: There was a significant difference (P<0.05) in the decrease in levels of interleukin 6, procalcitonin, and microbial count in the treatment group compared to the control group. There was no significant difference (P>0.05) in the improvement in the histopathology of the lungs in the treatment group compared to the control group. Conclusion: Curcuma longa extract can significantly reduce levels of interleukin 6, procalcitonin, and microbial count, but not significantly improve the histopathology of the lung.

Comparison of NEWS, SIRS, and qSOFA Score as Predictors of Mortality and Length of Stay in Patients Pneumonia with Sepsis Harsini, Harsini; Alfarizi, Aditya; Aphridasari, Jatu; Raharjo, A Farih; Reviono, Reviono
Jurnal Respirologi Indonesia Vol 44 No 1 (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.v44i1.505

Background: Pneumonia is a major health problem in all age groups and often related with sepsis. In 2021, Surviving Sepsis Campaign Guidelines mentioned several clinical scoring systems to identify patients with potentials of developing sepsis, such as systemic inflammatory response syndrome (SIRS), national early warning score (NEWS), quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA). The guideline stated that there is no gold standard for diagnosing sepsis, contradicting The Sepsis-3 Guideline in 2016 that mentioned SOFA score as a gold standard for diagnosing sepsis.Methods: Subjects were all patients with pneumonia and sepsis who were treated in Dr.Moewardi Hospital within 1 January to 31 December 2022. Data from subjects’ medical records were collected to assess their NEWS, SIRS, qSOFA, and SOFA score on the day of admission. Since evaluation of SOFA score needs a number of components requiring laboratory results and takes longer time so they made a simpler tool called qSOFA to avoid delayed treatment of the patients.Results: NEWS is more consistent with SOFA compared to SIRS and qSOFA (Kappa value = 0.726 vs 0.320 vs 0.22; respectively). NEWS, SIRS, and qSOFA were all significantly correlated with mortality (P<0.001) with NEWS having the strongest correlation (r=0.482 vs 0.216 vs 0.175; respectively). Only NEWS showed significant correlation with the length of stay (r=0.129; P<0.001).Conclusion: NEWS was the most consistent score to SOFA compared to SIRS and qSOFA. NEWS was also the best predictor for mortality and was the only score correlated with length of hospital stay.

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