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All Journal Nexus Kedokteran Komunitas Nexus Kedokteran Klinik Jurnal Respirologi Indonesia Jurnal Respirasi (JR) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Ana Rima Setijadi
Faculty of Medicine, Sebelas Maret University
Health Professions Medicine & Pharmacology Public Health

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Effect of Balloon Inflation Exercise on Lung Function, Resilience, and Quality of Life in Patients Stable Copd RS UNS Pratiwi, Atmasari; Apriningsih, Hendrastutik; Setijadi, Ana Rima; Adhiputri, Artrien; Rahardjo, A. Farih
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.v45i3.492

Abstract

Background: His WHO data for 2019 puts him third in COPD deaths, at about 3.23 million. Decreased respiratory function is one of the symptoms of COPD that causes respiratory arrest that impacts quality of life. Pulmonary rehabilitation in COPD patients is a means of controlling and reducing symptoms and optimizing functional function.Method: Experimental study with pre-test and post-test groups design. The number of study participants was 30 stable COPD outpatient in group B and E of the Respiratory Clinic of the UNS Hospital during the period of February 2023 by targeted sampling. The control group (n = 15) received standard care and the treatment group (n=15) received standard care plus additional balloon-inflation exercises for 6 weeks. Comparisons between pretest and posttest groups were made on %VEP1 score, breathlessness symptoms, CAT questionnaire, exercise capacity, and EID.Result: Increased values of %VEP1 (p=0.001), decreased Borg scale (p=0.001), decreased CAT score (p = <0.001), and physical activity performance (p = 0.001) versus his EID (p = <0.001) increase.Conclusion: Inflating the balloon affects %VEP1, Borg scale, CAT score, training capacity increase, and EID values. Balloon blowing exercise increases the %VEP1 value, lowers the Borg scale, lowers the CAT score, increases exercise capacity, and EID.Keywords: %VEP1, Borg scale, training capacity, CAT, EID
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

Abstract

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.
Thymoma Profile at Dr. Moewardi General Hospital: Does Thymoma Size Really Affect Distant Metastasis? Thomas, Novita Silvana; Fahlevie, Fahlevie; Setijadi, Ana Rima; Widiastuti, Widiastuti; Rakhma, Sastia
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.1.2024.30-35

Abstract

Introduction: Size is a predictor factor of a patient's prognosis and metastasis in solid tumors. This study determined the relationship between thymoma size and distant metastasis. Methods: A cohort retrospective study using medical record data was conducted at Dr. Moewardi General Hospital, Surakarta, from January 2019 to August 2021. Of 1,430 thoracic oncology patients, 150 (10%) had mediastinal mass with thymoma as the majority (48.6%). About 73 thymoma patients were included. The size of the thymoma was the dependent variable, and the metastasis (distant and non-distant) was the independent variable. The cut-off point of thymoma size was determined with receiver operating characteristic (ROC) analysis. The correlation of thymoma size with distant metastasis was analyzed with the Chi-Square test, and p < 0.05 was considered significant. Results: Thymoma was predominated by males (53.4%), the mean age was 43 ± 16 years old, and dyspnea was the most common symptom. Metastatic lesions were found in 87.7% of the patients, and the most common metastatic sites were intrathoracic (79.5%), followed by axillary lymph nodes (49.3%), bone (21.9%), liver (20.5%), and brain (1.4%). The cut-off value of thymoma size was 8.25 cm, indicating that >8.25 cm was categorized as large thymoma. Distant metastasis was found in 86.0% of large thymoma patients. The large tumors tend to spread into various sites (OR = 5.39; 95% CI 2.8-32.6; p = 0.002).   Conclusion: Thymoma must be taken into account when there are male patients in their forties presented with dyspnea and mediastinal mass. The cut-off point of 8.25 cm for the thymoma size can predict distant metastasis.
The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia Syahruddin, Elisna; Soeroso, Noni Novisari; Ananda, Fannie Rizki; Wulandari, Laksmi; Setijadi, Ana Rima; Ermayanti, Sabrina; Pratiwi, Suryanti Dwi; Infianto, Andreas; Andayani, Novita; Munir, Sri Melati; Pratama, Avissena Dutha; Kusumawardani, Ida Ayu Jasminarti Dwi; Haryati, Haryati; Duyen, Natalie; Hanif, Muhammad Alfin; Lim, Darren Wan-Teck
Jurnal Respirasi Vol. 11 No. 1 (2025): January 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.1.2025.22-30

Abstract

Introduction: Targeted therapy, particularly epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), is the first-line treatment for non-small cell lung cancer (NSCLC). However, drug resistance has grown in the last few decades. This study compared the progression time of lung cancer patients treated with first- and second-generation EGFR-TKI. Methods: Based on cytology and histological results, this cross-sectional study included 1,008 participants diagnosed with lung adenocarcinoma (LUAD) from 11 Indonesian Respiratory Centers. Every three months, the response to treatment was assessed using the Response Evaluation Criteria in Solid Tumours (RECIST) criteria in 1.1. Significant differences in the clinical features of the three TKI treatment groups were identified using logistic regression analysis, the median time to disease progression was estimated using the Kaplan-Meier technique, and independent prognostic factors related to the time to progression (TTP) were assessed using Cox proportional hazards regression. Results: This study examined 505 patients, the majority of whom were females (50.9%), never smoked (59.8%), diagnosed at an advanced stage (99.2%), and had an Eastern Cooperative Oncology Group (ECOG) scale of 0-1 (83.2%). Approximately 98.1% of patients were treated with afatinib (14.8%), erlotinib (18.6%), and gefitinib (66.1%) due to common mutations. The groups did not differ significantly (p>0.05). The median overall survival (OS) rate was 9 months. The time to LUAD progression in lung cancer was significantly impacted by poor performance (p=0.001). Conclusion: Epidermal growth factor receptor-tyrosine kinase inhibitor treatment can only prolong the TTP of LUAD by up to 9 months, and the performance scale when receiving the EGFR-TKI significantly affects the prognosis.
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. 
The Role of Omega-3 on the IL-6 Levels, Malondialdehyde, and Clinical Improvement in Adults with Community-Acquired Pneumonia Astarini, Dewi; Aphridasari, Jatu; Setijadi, Ana Rima
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.v44i1.402

Abstract

Background: Acute lung parenchymal infection, known as pneumonia, can be carried on by multiple microorganisms, including bacteria, viruses, fungi, and parasites. Globally, community-acquired pneumonia is a major factor of morbidity, mortality, and health issues. Malondialdehyde (MDA) is a marker of oxidative stress in pneumonia patients, and interleukin 6 (IL-6) is a marker of inflammatory process. Effect of Omega-3 as an immunomodulator, anti-inflammatory, and antioxidant may be implemented as adjunctive therapy in patient with community-acquired pneumonia.Methods: Clinical trial research with a true experimental method and pretest-posttest design. The study involved 30 community-acquired pneumonia patients who were admitted at Moewardi Hospital in Surakarta and Dr. Soehadi Prijonegoro Hospital in Sragen from August to September 2022 by consecutive sampling. The control group (n=15) received standard therapy, and the treatment group (n=15) received standard therapy plus Omega-3 at a dose of 1600 mg/day. IL-6 and MDA levels were measured when the subject was admitted to the hospital and there was clinical improvement.Results: There was a significant difference in reduced IL-6 levels (P=0.001), decreased MDA levels (P=0.001), and the duration of clinical improvement (P=0.042) between the treatment group and the control group. There was a moderate correlation between the decrease in IL-6 (R=0.480) and MDA (R=0.459), while the duration of clinical improvement had a strong correlation (R=0.756) in the treatment group.Conclusion: Supplementation of Omega-3 was effective in reducing IL-6, MDA levels, and the duration of clinical improvement in community-acquired pneumonia patients.
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

Abstract

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.
The Relation between D-Dimer, Hs-CRP, and ACE Inhibitor to Severity, Reinfection, and Mortality of COVID-19 Patients Thomas, Novita Silvana; Aphridasari, Jatu; Setijadi, Ana Rima
Jurnal Respirologi Indonesia Vol 44 No 4 (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.v44i4.465

Abstract

Background: COVID-19 reinfection has been found, although the data is not clear yet. Pandemic conditions bring about limited facilities and infrastructure, so biomarkers are an option. Research on biomarkers and the use of ACE inhibitor drugs in COVID-19 patients has not been widely conducted in Indonesia.Methods: This was a retrospective cohort study that used medical record data of confirmed COVID-19 patients treated at dr. Moewardi General Hospital for the period of January to March 2022. Surviving patients were observed for reinfections until November 2022.Results: This study involved 524 medical records of confirmed COVID-19 patients. After exclusion and inclusion criteria, 517 medical records were obtained. D-Dimer cut-off values of ≥2435 were significantly related to severity (OR=2.05; 95% CI=1.38-3.06; P≤0.001) and mortality (OR=2.89; 95% CI=1.95-4.27; P≤0.001) of COVID-19 patients. Hs-CRP levels ≥4.59 were significantly associated with mortality in COVID-19 patients (OR=1.82; 95% CI=1.23-2.69; P=0.003). The use of ACE inhibitors (OR=0.55; 95% CI=0.33-0.89; P=0.015) was a protective factor from mortality but increased the risk of reinfection (OR=3.11; 95% CI=1.16-8.36; P=0.034). Conclusion: D-Dimer and Hs-CRP biomarkers could be considered as predictor biomarkers for the severity and mortality of COVID-19 patients. Although the use of ACE inhibitors increased the risk of reinfection, it reduced the risk of mortality due to COVID-19.
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.
Indonesian Society of Respirology Position Paper on Lung Cancer Control in Indonesia Andarini, Sita; Santoso, Andintia Aisyah; Arfiansyah, Mochammad Aris; Syahruddin, Elisna; Zaini, Jamal; Putra, Andika Chandra; Kurniawan, Ferry Dwi; Ermayanti, Sabrina; Soeroso, Noni Novisari; Munir, Sri Melati; Infianto, Andreas; Setijadi, Ana Rima; Setyawan, Ungky Agus; Wulandari, Laksmi; Haryati, Haryati; Jasminarti, Ida Ayu; Hidayat, Moulid; Santoso, Arif
Jurnal Respirologi Indonesia Vol 44 No 4 (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.v44i4.884

Abstract

Lung cancer is a major health concern in Indonesia due to its increasing prevalence, late-stage diagnosis, younger population, and high mortality. Addressing this issue requires nationwide implementation of comprehensive lung cancer control, which includes risk reduction and prevention strategies, focusing on tobacco control and air pollution mitigation. Screening with low-dose computed tomography (LDCT) and early detection in symptomatic patients, along with TB screening programs and all non-communicable diseases, is strongly recommended to enhance early case findings, treatment effectiveness, and overall patient outcomes. A multidisciplinary team (MDT) approach is important to ensure accurate diagnosis and comprehensive care. Moreover, the integration of palliative care at the early stages of advanced lung cancer is vital, focusing on symptom management and enhancing the quality of life for patients. While national guidelines are available for the diagnosis and treatment of lung cancer, significant disparities in healthcare access remain across Indonesia. Thus, it is essential to improve universal health coverage and referral systems to guarantee equal access to lung cancer care for patients at all levels through advocacy and ease of access.
Co-Authors . Widardo Adhiputri, Artrien Amelia Yunita Ananda, Fannie Rizki Andarini, Sita Apriningsih, Hendrastutik Arfiansyah, Mochammad Aris Arif Santoso Arum Alfiyah Fahmi Astarini, Dewi Atmojo, Anang Purwoko Duyen, Natalie Elisna Syahruddin Ermayanti, Sabrina Fahlevie, Fahlevie Fitria Marizka Kusumawardhany Hanif, Muhammad Alfin Harsini , Harsini Haryati Haryati Hidayat, Moulid Ida Ayu Jasminarti Dwi Kusumawardani Imaniar Hidayati Arindha Infianto, Andreas Ivan Setiawan Jasminarti, Ida Ayu Jatu Aphridasari Kurniawan, Ferry Dwi Laksmi Wulandari Lestari, Anggraini Dwi Lim, Darren Wan-Teck Noni Novisari Soeroso Novi primadewi Novita Andayani, Novita Novita Silvana Thomas, Novita Silvana Nur Hafidha Hikmayani Pratama, Avissena Dutha Pratiwi, Atmasari Pratiwi, Suryanti Dwi Putra, Andika Chandra Rahardjo, A. Farih Raharjo, A. Farih Rakhma, Sastia Reviono Reviono Reviono Rizka Ratmilia Santoso, Andintia Aisyah Setyawan, Ungky Agus Sibarani, Lia Priscilia Sri Melati Munir Sumardiyono Sumardiyono Tamaulina Br Sembiring Widardo . WIDIASTUTI - Yanuar Yudhi Prasetyo, Yudhi Yusup Subagio Sutanto Zaini, Jamal