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The Effect of Roflumilast on Absolute Neutrophil Count, MMP-9 Serum, % VEP1 Value, and CAT Scores in Stable COPD Patients Ratna Adhika; Suradi Suradi; Yusup Subagio Sutanto
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.265

Abstract

Background: Chronic obstructive pulmonary disease is the leading cause morbidity and mortality worldwide. Cigarette smoke and noxious agent causing oxidative stress activated nuclear factor-κB then increase inflammatory cell releases. Roflumilast have antiiinflammatory effect which can be use as addition therapy for stable COPD.Methods: The pretest and postest experimental clinical trial was carried out in 40 patients with stable COPD in the pulmonology outpatient clinics of Dr. Moewardi Surakarta and dr. Soehadi Prijonegoro Sragen hospital from 6 January to 6 March 2020. Forty subjects were grouped into treatment group (n=20) receiving standart therapy along with roflumilast 500 mg/day and placebo group (n=20) receiving standart therapy only for 28 days. Decreased inflammation measured by ANC and serum MMP-9, improvement of obstruction measured by % FEV1, and clinic improvement measured by CAT score.Results: Our finding revealed decreases of ANC and MMP-9 serum in the treatment group, although statistically insignificant (p=0,449), (p= 0,195) respectively. %VEP1 value increased insignificant in the treatment groups (p=0,189). Chronic obstructive pulmonary disease assessment test (CAT) score decreased significantly in the treatment group (p=0.000).Conclusion: Roflumilast administration reduce inflammation as it can lower not significant ANC, MMP-9 serum, higher not significant %VEP1, and improves the clinical condition of patients with stable COPD based on a decrease in CAT score.
New GOLD COPD Guideline 2019: How We Deal with It? (Inhaled Corticosteroid Use and Blood Eosinophil Count) Ari Julian Saputra; Kiki Widyastuti; Yusup Subagio Sutanto
Respiratory Science Vol. 1 No. 2 (2021): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v1i2.13

Abstract

Background: Blood eosinophils may predict response to inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD), where ICS is recommended in patients at high risk of exacerbations by the Global Initiative for COPD (GOLD) strategy. It can help clinicians to estimate the likelihood of beneficial preventive responses to the addition ICS to regular bronchodilator treatment, and thus can be used as a biomarker in conjunction with clinical assessment when making decisions regarding ICS use. This study aims to compare therapeutic data with blood eosinophil count in COPD patients. Methods: Data were collected from consecutive COPD outpatients in Bukit Asam Medika Hospital starting from March 1st, 2019 until June 30th, 2019 and dr. H. Mohamad Rabain Hospital starting from Oct 1st, 2019 until Dec 27th, 2019. We collected demographics, anthropometrics, smoking history, therapy, dynamic lung volumes, the Medical Research Council scale (MRC), CAT score, and blood eosinophil count. Results: From 57 data collected, 24 (42,1%) patients were having blood eosinophil count ≥300. Patients who have more exacerbation in COPD Group C were 33,3% and 63,2% in COPD Group D. The proportions of ICS-treated COPD Group D patients and blood eosinophil count of <300 and ≥300 was 63,9% and 36,1%, respectively. Conclusion: This study may provide information and characteristic of COPD patient in Indonesia rural area and showed who may have benefit to ICS therapy based on recommendation GOLD COPD 2019. Blood eosinophils counts is a low-cost biomarker and may help clinicians to made decision therapy.
Hubungan Kategori Level Xpert MTB/RIF dengan Waktu Konversi Kultur Sputum Pasien TB Resisten Obat (TB RO) Samuel -; Jatu Apridasari; Reviono -; Yusup Subagio Sutanto; Harsini -
Cermin Dunia Kedokteran Vol 47, No 11 (2020): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i11.1194

Abstract

Penanganan TB yang tidak tepat dan tidak sesuai standar dapat menimbulkan masalah TB resisten obat (TB RO). Penelitian ini bertujuan mengetahui hubungan antara kategori level hasil Xpert MTB/RIF dengan waktu konversi kultur sputum pasien TB RO. Data berasal dari rekam medik mulai bulan September 2012 sampai dengan bulan Oktober 2015; didapatkan 198 pasien TB RO, 112 laki-laki (56,6%) dan 86 perempuan (43,4%).Usia rerata 38,87 ± 12,41 tahun. Seluruh pasien TB RO merupakan pasien TB paru dengan memiliki riwayat pengobatan OAT kategori 1. Hasil pemeriksaan Xpert MTB/RIF menunjukkan sebagian besar pasien TB RO berada pada kategori low (43,9%). Konversi kultur terbanyak pada minggu ke empat sampai ke delapan pengobatan sebesar 59,1%. Tidak ada perbedaan bermakna antara kategori Xpert MTB/RIF dengan waktu konversi kultur sputum pasien TB RO (CI 95%, p = 0,572). Tidak ada korelasi bermakna antara kategori level gene X-pert dengan waktu konversi kultur sputum pasien TB RO (CI 95%, r = 0,061, p = 0,392).Inadequate TB management can cause the emergence of drug resistant tuberculosis. This study is to determine the correlation between Xpert MTB/RIF levels category with sputum culture conversion time in drug resistant tuberculosis patients. This retrospective cohort study was conducted in PMDT clinic at Dr. Moewardi General Public Hospital, Surakarta from September 2012 until October 2015. The respondents were 198 drug resistant tuberculosis patients; 112 males (56.6%) and 86 females (43.4%), mean age 38.87 ± 12.41 years old. All were pulmonary TB patients with category 1 anti-TB treatment. The Xpert MTB/RIF levels were mostly low category (43.9%).Culture conversion showed that 59.1% had conversion between the fourth and eighth week of drug resistant tuberculosis treatment. No statistically significant difference between Xpert MTB/FIR level category and sputum culture conversion time (CI 95%, p = 0.572). No statistically significant correlation between Xpert MTB/RIF level category and sputum culture conversion time (CI 95%, r = 0.061, p = 0.392).
Combined Upper Limb Exercise and Creatine Monohydrate Supplementation Improved Musculoskeletal Function in NSCLC Patients Muhammad Addinul Huda; Ana Rima Setijadi; Reviono Reviono; Farih Raharjo; Yusup Subagio Sutanto
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
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.v42i4.310

Abstract

Background: Lung cancer is a chronic respiratory disease that causes muscle dysfunction. Giving creatine monohydrate supplementation combined with exercise has efficacy in increasing lean body mass (LBM), muscle strength, and physical function. This study aims to analyze the effect of a combination of creatine monohydrate supplementation and upper limb exercise on skeletal muscle dysfunction in NSCLC patients.Methods: A quasi-experimental study with a pretest-posttest study on NSCLC patients given epidermal growth factor receptor (EGFR) – tyrosine kinase inhibitors (TKIs) from outpatient at RSUD Dr. Moewardi Surakarta in September - October 2021. The combination group of creatine monohydrate supplementation with upper limb exercise (n=15), the group with creatine monohydrate supplementation only (n=16), and the control group (n=15). Lean body mass in kilograms and percentages, 6-minute walk test (6MWT), and quality of life were assessed after 8 weeks of treatment.Results: The increase in LBM in the combination group was 4.22±1.81kg and 6.38±2.48% (P=0.0001). The combination groups have a greater increase in the 6MWT was 104±20.07 meters. The increase in quality of life in the combined creatine monohydrate supplementation group with upper limb exercise was 20.80±10.75. Changes in the value of LBM, 6MWT, and quality of life (QoL) in the creatine monohydrate supplementation combined with upper limb exercise were significantly different compared to the creatine monohydrate supplementation only group and the control groups.Conclusion: There is a greater effect of giving a combination of creatine monohydrate supplementation and upper limb exercise on LBM, 6MWT, and QoL in NSCLC patients.
Lidocaine Nebulization Compared to Lidocaine Spray in Decreasing Pain, Cough and Breathless in Flexible Fiber Optic Bronchoscopy Vita Ovaria; Yusup Subagio Sutanto; Ahmad Farih Raharjo
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
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.v42i4.368

Abstract

Background: Flexible optical fiber bronchoscopy (FFB) is a visual airway tract examination for diagnostic and therapeutic purposes. This procedure often causes discomfort for patients, such as cough, breathlessness and pain. Lidocaine is a topical anesthetic premedication used in bronchoscopy. This study compared the use of lidocaine nebulization and lidocaine spray in inhibiting pain, cough and breathlessness in complexity of flexible fiber optic bronchoscopy.Methods: Pretest and posttest control group clinical study was conducted in patients prior to bronchoscopy at RSUD Dr. Moewardi from February to March 2020. The samples were taken by consecutive sampling technique, then randomly assigned into either lidocaine spray or nebulization. Cough and pain were assessed with VAS score while breathlessness was assessed with Borg score. The data were analyzed statically by using Chi-square test with P<0.05 was considered significantResults: Cough scores were -17.78±11.66 for nebulization and -8.33±6.18 for spray (P=0.005). Pain score were -16.67±11.38 and -9.44±7.25 for nebulization and spray respectively (P=0.045). Borg score obtained the scores for nebulization and 0.06±0.42 for spray (P=1.000).Conclusion: Both lidocaine nebulization and spray were effective in decreasing breathlessness during bronchoscopy. However, lidocaine nebulization was more effective in decreasing cough and pain.
Delayed Treatment and Adverse Effects of Drug Resistance Tuberculosis Impact on Outcome, Survival and Quality of Life Linda Soebroto; Reviono Reviono; Yusup Subagio Sutanto; Farih Raharjo; Jatu Aphridasari
Jurnal Respirologi Indonesia Vol 43, No 1 (2023)
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.v43i1.259

Abstract

Background: Global TB Report 2020 states that 78% of tuberculosis patients experience drug resistancy with a global treatment success rate of 57%. Drug resistance tuberculosis (DR TB) patients whom experience side effects such as arthralgia and hyperuricemia with inadequate treatment will affect the treatment result.Methods: Retrospective cohort study to DR TB patients who underwent treatment from January 2015 to August 2020 at RSUD dr. Moewardi Surakarta. Survival analysis using Kaplan Meier method and Cox regression test for the effect of risk factors on the safety and survival of TB RO patients. Quality of life analysis using Mann Whitney test.Results: From 372 patients, delayed treatment factor (OR=2.906; 95% CI=1.890-4.469; P≤0.001) and arthralgia factor (OR=1.775; 95% CI=1.148-2.744; P=0.010) were variables that had a significant effect on recovery of DR TB patients. Delayed treatment and arthralgia have risk (2,906 times and 1.775 times) for non-recovered DR TB patients. Delayed treatment factor with HR=14.772 (95% CI=13.381-16.163), arthralgia with HR=15.170 (95% CI=13.960-16.379), and anemia with HR=15.304 (95% CI=14.074-16.535; P=0.002) affect on the survival of DR TB patients. Anemia affect on the quality of life DR TB patients.Conclusion: Delayed treatment for more than 14 days and arthralgia that is not treated adequately can affect the recovery of DR TB patients. The survival and quality of life of DR TB patients can be increased by monitoring the time of taking medication, monitoring side effects of drugs such as arthralgia, and adequate nutritional intake so that anemia does not occur.
The Degree of Inflammation and Length of Hospital Stay in Acute Exacerbation of COPD Patients After Secretome Administration Hendrastutik Apriningsih; Yusup Subagio Sutanto; Reviono Reviono; Artrien Adhiputri; Windu Prasetya; Fahlevie Fahlevie; Fitrotin Aziza
Jurnal Respirologi Indonesia Vol 43, No 1 (2023)
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.v43i1.390

Abstract

Background: Acute exacerbation of COPD (AECOPD) is a decrease in respiratory conditions compared with regular conditions that require additional treatment, increase risk of hospitalization or demand intensive care unit. The neutrophil-to-lymphocyte ratio (NLR) describes the balance between the severity of inflammation and the immune system and is considered as an important systemic inflammatory marker. Length of hospital stay (LHS) is important in predicting the severity of AECOPD, in which longer LHS indicates greater severity of AECOPD. Secretome has been shown to have the ability to exert immunomodulatory effects, reduce lung injury and inflammation in several models of lung inflammation and immune-mediated lung disease. This study aimed to assess the differences between NLR and LHS in AECOPD patients who received a secretome and those who did not.Methods: This study involved 30 AECOPD patients whom assigned into two groups. Secretome and standard therapy were administered in the treatment group, whilst the control group only received the standard therapy. Statistical analysis used different test, the unpaired group difference test using Mann Whitney and the independent test, the paired group difference test using Wilcoxon rank test and Pair test. Result is significant if the P<0.05.Results: NLR value in the treatment group experienced a lower increase than the control group, yet statistically insignificant (P=0,187). Secretome decreased the LHS in AECOPD patients, and statistically significant with (P=0,028). Conclusion: Administration of secretome led to a lower increase in NLR value and decreased LHS AECOPD patients.
Hubungan Kategori Level Xpert MTB/RIF dengan Waktu Konversi Kultur Sputum Pasien TB Resisten Obat (TB RO) Samuel; Jatu Apridasari; Reviono; Yusup Subagio Sutanto; Harsini
Cermin Dunia Kedokteran Vol 47 No 9 (2020): Infeksi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v47i9.565

Abstract

Penanganan TB yang tidak tepat dan tidak sesuai standar dapat menimbulkan masalah TB resisten obat (TB RO). Penelitian ini bertujuan mengetahui hubungan antara kategori level hasil Xpert MTB/RIF dan waktu konversi kultur sputum pasien TB RO. Data berasal dari rekam medik mulai bulan September 2012 sampai dengan bulan Oktober 2015; didapatkan 198 pasien TB RO, 112 laki-laki (56,6%) dan 86 perempuan (43,4%). Usia rerata 38,87 ± 12,41 tahun. Seluruh pasien TB RO merupakan pasien TB paru dengan memiliki riwayat pengobatan OAT kategori 1. Hasil pemeriksaan Xpert MTB/RIF menunjukkan sebagian besar pasien TB RO berada pada kategori low (43,9%). Konversi kultur terbanyak pada minggu ke-4 sampai ke-8 pengobatan sebesar 59,1%. Tidak ada perbedaan bermakna antara kategori Xpert MTB/RIF dan waktu konversi kultur sputum pasien TB RO (CI 95%, p = 0,572). Tidak ada korelasi bermakna antara kategori level gene X-pert dan waktu konversi kultur sputum pasien TB RO (CI 95%, r = 0,061; p = 0,392). nadequate TB management can cause the emergence of drug resistant tuberculosis. This study is to determine the correlation between Xpert MTB/RIF levels category with sputum culture conversion time in drug resistant tuberculosis patients. This retrospective cohort study was conducted in PMDT clinic at Dr. Moewardi General Public Hospital, Surakarta from September 2012 until October 2015. The respondents were 198 drug resistant tuberculosis patients; 112 males (56.6%) and 86 females (43.4%), mean age 38.87 ± 12.41 years old. All were pulmonary TB patients with category 1 anti-TB treatment. The Xpert MTB/RIF levels were mostly low category (43.9%). Culture conversion showed that 59.1% had conversion between the fourth and eighth week of drug resistant tuberculosis treatment. No statistically significant difference between Xpert MTB/FIR level category and sputum culture conversion time (CI 95%, p = 0.572). No statistically significant correlation between Xpert MTB/RIF level category and sputum culture conversion time (CI 95%, r = 0.061; p = 0.392)
Is Docetaxel the Main Therapy for Lung Metastasis in Granular Cell Tumors? Heru Sigit Pramono; Ana Rima Setijadi; Yusup Subagio Sutanto; Brian Wasita
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.130-135

Abstract

Introduction: A granular cell tumor is a rare neoplasm originating from mesenchymal tissue. Malignant granular cell tumors have a poor prognosis. The lung is one of the target organs for metastatic malignant granular cell tumors. The number of rare cases makes managing metastatic malignant granular cell tumors unknown. Case: A 19-year-old male complained of shortness of breath for two months. A liver nodule biopsy revealed poorly differentiated carcinoma metastases. Histopathology of the left manus and frontal masses found granular cell tumors”negative immunohistochemistry on S-100 and myogenin. Ki-67 obtained a value of 5%. An X-ray and contrast multislice computerized tomography (MSCT) scan showed multiple metastatic nodules. Right bronchial biopsy forceps revealed a metastatic granular cell tumor. The patient was given docetaxel for six cycles. During the post-administration of docetaxel, the patient experienced clinical and radiological improvement. Conclusion: Until 2016, only three case reports of S-100 negative granular cell tumors existed. A negative S-100 test does not rule out the diagnosis of granular cell tumors. Malignant lesions are more common in males, as in this case. The number of rare cases means that management cannot be determined. Reports of similar cases show patients surviving up to 11 years with docetaxel administration. The patient in this study has survived for one year and is complaint-free.
Tuberculin Skin Test and T-SPOT.TB for Latent Tuberculosis Infection detection in healthcare workers Yusup Subagio Sutanto; Paulus Arka Triyoga; Harsini Harsini; Reviono Reviono; Hendra Kurniawan
Jurnal Kesehatan Masyarakat Vol 18, No 4 (2023)
Publisher : Department of Public Health, Faculty of Sport Science, Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v18i4.39528

Abstract

Healthcare Workers (HCWs) have a higher risk of getting Tuberculosis (TB) than the general population. This study analyzed effectiveness of Tuberculin Skin Test (TST) and T-SPOT.TB for detection prevalence of Latent Tuberculosis Infection (LTBI) among HCWs and the correlation between work locations and HCW duties. A trial study with a cross-sectional study design in Dr. Moewardi Hospital, Surakarta, in December 2018. The sampling technique used consecutive sampling with 30 subjects. Data analysis was performed using SPSS 21 for Windows. The appropriate levels of TST and T-SPOT indicated substantial TB (K = 0.603, p 0.001). The sensitivity and specificity of T-SPOT.TB with close contact was 60% and 86.7%. The sensitivity and specificity of TST with close contact were 33.3% and 93.3%. T-SPOT.TB was a significant correlation between the work location, the pulmonary care ward r = 0.436 and p = 0.008 (p 0.05). T-SPOT.TB has a slightly better sensitivity than TST.
Co-Authors -, Harsini -, Reviono . Reviono Adam Prabata Adhiputri, Artrien Agnes Sri Harti Agnes Sri Harti Agnes Sri Harti Agnes Sri Harti Akhmad Syaikhu Ana Rima Ana Rima Setijadi Ana Rima Setijadi Ana Rima Setijadi Anindita Hapsari, Brigitta Devi Aphridasari, Jatu Apridasari, Jatu Apriningsih, Hendrastutik Ari Julian Saputra Ari Natalia Probandari Artrien Adhiputri Arwin Muhlishoh Atmojo, Anang Purwoko Avamira Rosita Pranoto Bambang Abdul Syukur Bambang Abdul Syukur Bhisma Murti Brian Wasita Brian Wasita Caesaria Sarah Selleca Debree Septiawan Debree Septiawan Dhani Redhono, Dhani Diana Kurniasari Sagita Fahlevie Fahlevie Farih Raharjo Fitrotin Aziza Hari Wujoso Harsini Harsini , Harsini Harsini Harsini Hendra - Kurniawan Hendra Kurniawan Hendra Kurniawan Hendrastutik Apriningsih Hendrastutik Apriningsih Hermiana Ernastin Tobi Heru Sigit Pramono Ita Haryatie Jatu Aphridasari Jatu Apridasari Jatu Apridasari Jatu Aviani Jerry Indra Setiawan Kiki Widyastuti Kurniawan, Yoseph Dwi Larissa Amanda Leli Saptawati Lestari, Anggraini Dwi Liana Herlina Linda Soebroto Luths Maharina Magdalena - Sutanto Magdalena Sutanto Maria Dewi Caetline Maria Dewi Caetline marwoto marwoto Mellia Silvy Irdianty Mia Herdiyani Achmad Mochammad Imron Awalludin Muhammad Addinul Huda Murti, Paulus Wisnu Kuncoro Muttaqin Huda Nony Puspawati Nony Puspawati Nugroho, I.G.B Indro Nur Amalia Santang Nurul Devi Ardiani Nurul Devi Ardiani, Nurul Devi Paulus Arka Triyoga Putranto, Wachid R, Sari Apriliana Rahajeng Putriningrum Raharjo, A. Farih Ratna Adhika Reviono Reviono - Reviono Reviono Reviono Reviono Reviono Reviono Reviono Reviono Reviono Reviono Roman Diaz Rullyano Hardian Saelan, Saelan Safina Mutmainnah Samuel Samuel - Samuel - Samuel Samuel Santi, Nur Satria Maulana EH Sebayang, Pribadi M Septiawan, Debree Sibarani, Lia Priscilia Sigit, Indarto Siregar, Sihsusetyaningtyas Tiominar Soetejo, FX Sri Haryati Subandrio, Subandrio Sulistyani Kusumaningrum Suradi Suradi Suradi Suradi Suradi Suradi SURYAWATI, BETTY Sutanto, Magdalena Sutanto, Magdalena Sutanto Teguh Budi Santosa Vita Ovaria Wahyu Rima Agustin Wahyuningsih Safitri, Wahyuningsih Wati, Martha Ratna Widiastuti Widiastuti Widyasanti, Diana Windu Prasetya Windu Prasetya Windu Prasetyo Yanny Octavia Sally Ride Yogie Irawan Yundari, Yundari