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All Journal Medula Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Respirasi (JR) Jurnal Aisyah : Jurnal Ilmu Kesehatan JK Unila (Jurnal Kedokteran Universitas Lampung) Mamangan Social Science Journal
Adityo Wibowo, Adityo
Bagian Fisiologi, Fakultas Kedokteran, Universitas Lampung
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary

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Rapid Diagnosis and Management of Concomitant Acute Cardiogenic Pulmonary Edema and Community-Acquired Pneumonia Increase Patient Survival Wibowo, Adityo; Saputra, Tetra Arya
Medula Vol 14 No 2 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i2.961

Abstract

Acute pulmonary edema is a potentially life-threatening complication of cardiac disease that leads to acute respiratory failure. Cardiogenic pulmonary edema affects approximately 80% of patients with acute decompensated heart failure. Acute pulmonary edema caused by heart failure affects nearly a million individuals annually, and the number of cases is growing significantly as the ejection fraction reduces. The clinical presentation can be identified by a sudden onset of dyspnea and a quick accumulation of fluid inside the alveolar and lung interstitial secondary to an increase in hydrostatic pressure. Community-acquired pneumonia (CAP) is the most common respiratory infection caused by a microbial infection of the lung parenchyma and has almost similar clinical characteristics to acute pulmonary edema. The length of stay in hospital will increase nearly two times longer in these concomitant diseases. Comorbidity of cardiogenic lung edema and CAP increase mortality rate by nearly 25% in heart failure patients without early detection and proper management.
Proper Management of Underweight and Anemia in Tuberculosis Patients Increases The Improvement Time During Two-Week Treatment Follow-Up Saputra, Tetra Arya; Wibowo, Adityo
Medula Vol 14 No 5 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i5.991

Abstract

Tuberculosis (TB) continues to be the leading cause of disease and mortality caused by chronic pulmonary infection. The World Health Organization (WHO) considers that one-third of the global population is infected with Mycobacterium tuberculosis (Mtb).  Mycobacterium tuberculosis infection results in persistent lung damage, which is characterized by ongoing inflammation that damages lung tissue. The patient additionally experienced a cough for almost one month, with clear mucous, absence of blood, and mild shortness of breath. Patients had decreases in body weight and loss of appetite for about three weeks. Night sweats appeared within one month. There was no specific complaint of gastrointestinal symptoms. The patient's nutritional management was focused primarily on oral intake, with a total daily consumption of 1690 kcal. The daily protein, carbohydrate, and fat consumption is divided into 42.45 grams of protein, 253.5 grams of carbohydrates, and 37.5 grams of fat. There was no history of food allergy from the patient, therefore we decided not to impose any dietary restrictions. The improvement in body weight was used to monitor the outcome of the nutritional intervention. Nutritional issues have emerged as a significant contributor to an increasing percentage of individuals with low hemoglobin (Hb), influencing TB-related morbidity. The most prevalent causes of anemia in tuberculosis are nutritional deficiencies and malabsorption as a result of appetite loss. Poor intake of food has also been linked to an increased risk of disseminated TB. To improve treatment outcomes, nutritional support should be provided in addition to tuberculosis medicine.
Lung Abscess Located in Lesion of Lung Tumor and Multiple Cavities due to Pulmonary Tuberculosis: A Case Report Indriani, Sri Indah; Simatupang, Elvando Tunggul Mauliate; Wibowo, Adityo; Makmur, Andreas; Fidiawati, Wiwit Ade
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.1.2024.55-60

Abstract

Introduction: People with tuberculosis (TB) have an increased risk of pulmonary cancer. They are also disproportionately affected by risk factors like immune suppression, smoking, and alcohol misuse. A lung tumor is reported to have occurred after an episode of TB, but we reported a patient with a lung tumor with co-infection TB and lung abscess at the same time. Case: A 73-year-old man was hospitalized at Arifin Achmad General Hospital, Pekanbaru, with a 3-day history of bloody cough 2-3 times a day, 1-2 tablespoons estimated by the patient for blood from the cough. The patient had a cough with white phlegm in the last 4 months before the bloody cough. The patient also had a fever, night sweats, a limp body, decreased appetite for 6 months, and decreased body weight by 15 kg in the last year. Heterogenic consolidation on the superior lobe of the lung with prominence compression and irregular boundaries in the apex was found. We found an air bronchogram and multiple cavities with air-fluid levels inside the lesion. We also found a satellite nodule in the inferior lung and a mass connected with the chest wall. GeneXpert showed low detection for Mycobacterium tuberculosis. The patient was diagnosed with a left lung abscess, pulmonary TB, left lung tumor T4N2M1a, unspecified type of tumor stage IVA PS2, and osteoporosis. Conclusion: Lung tumors could also be diagnosed with co-infection TB. Proper diagnosis to make sure cancer and TB are co-infected is necessary. Therefore, it will not be just a single disease that is treated.
Uncontrolled Type 2 Diabetes Mellitus Induces an Enterococcus faecalis Lung Abscess: A case report Aryana, Wayan Ferly; Wibowo, Adityo; Gozali, Achmad; Saputra, Tito Tri; SL, I Made Afryan; Febrihartati, Isura
Medula Vol 14 No 8 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i8.1184

Abstract

The incidence of lung abscess has increased due to the rise in antibiotic resistence, aging population, and immunocompromised patients.  Lung abscess is associated with high mortality rates, ranging from 1—20% globally, long treatment cycles, and significant management costs. Diabetes millitus affect innate and adaptive immunity, This dysregulation, microvascular complications, poor vascular flow, can further compromise an appropriate immune response and healing leading to worsening or secondary infections. Uncontrolled diabetes mellitus can lead patients to immunocompromised conditions, predisposing them to infectious disease. This study is a case report with data obtained through self-history, physical examination, and supporting examinations. A 49-year-old female patient presented with complaints of dyspnea, productive cough, and fever. The patient had a history of uncontrolled type 2 diabetes mellitus with fasting blood glucose 219 mg/dL. Chest examination showed a decreased of tactile fremitus on the left lung field, dullness on percussion of the left lung field, and decreased vesicular sound on auscultation of the left lung field. Laboratory and radiological examinations were also carried out. The CT show a well-demarcated lesion measuring 13.1x7.2x11.2 cm, air-fluid level (+), walled 0.5 cm thick  indicating suspicion of left lung abscess. The patient received treatments and showed clinical improvement so that therapy could be continued on an outpatient basis.
Pneumonia as a Secondary Complication Related to Inhaled Corticosteroid Combination Treatment for Chronic Obstructive Pulmonary Disease with Eosinophilic Phenotype Patient Wibowo, Adityo; Saputra, Tetra Arya
Medula Vol 14 No 8 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i8.1199

Abstract

Chronic obstructive pulmonary disorder (COPD) is a progressive respiratory condition characterized by chronic inflammation, proteases and antiproteases imbalance, and airway remodeling. Several hypotheses, including immune dysregulation, microbial colonization, and environmental triggers, explain the underlying cause of the deteriorating state and recurrence of exacerbations in COPD. Eosinophils, one of the inflammatory mediators, are involved in about 30% of cases of COPD. In COPD with an eosinophilic phenotype, specific therapy recommendations include inhaled corticosteroids (ICS) combined with a long-acting bronchodilator therapy typically includes the combination of inhaled corticosteroids (ICS) (e.g., fluticasone, budesonide) and a long-acting bronchodilator (LABA) (e.g., formoterol, salmeterol) to improve airflow and reduce inflammation. While ICS therapy is beneficial, side effects of pulmonary infections become more likely as the dose increases, particularly with prolonged use. The risk of pneumonia can be managed through dose optimization and careful patient monitoring.
Dramaturgy Of Advocates' Life In Forming Self Image Wibowo, Adityo; Zakiah, Zakiah
Jurnal Ilmu Sosial Mamangan Vol 12, No 3 (2024): Jurnal Ilmu Sosial Mamangan Accredited 3 (SK Dirjen Ristek Dikti No. 158/E/KPT/
Publisher : LPPM Universitas PGRI Sumatera Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22202/mamangan.v12i3.4925

Abstract

The law is, for those who are able to show their prowess, they can be guaranteed to have a high standard fee, and vice versa. Impression management is not formed just like that, it must be managed well, especially the actors must be able to implement dramaturgical concepts. The aim of this research is to analyze the dramaturgy of an advocate's life in forming a self- image. Case Study Research Method directly to advocate Rasnoto., S.H., M.H as the key person in implementing the dramaturgical concept in forming self image. The front stage and back stage are carried out by maintaining appearance and character management so as to create impression management. Personal front includes verbal language and body language of the actor, then personal front and setting are further divided into appearance. Impression management is not formed just like that, it must be managed well, especially the actors must be able to implement dramaturgical concepts. The aim of this research is to analyze the dramaturgy of an advocate's life in forming a self-image. Case Study Research Method directly to advocate Rasnoto., S.H., M.H as the key person in implementing the dramaturgical concept in forming self image. The front stage and back stage are carried out by maintaining appearance and character management so as to create impression management. Personal front includes verbal language and body language of the actor, then personal front and setting are further divided into appearance and style (manner). The appearance shown by Rasnoto is an authoritative and firm appearance on the front stage and a style (manner) that is adapted to the trial situation and/or location of the case. The back stage is the place where Rasnoto shows the true image of himself. The real self of Rasnoto that he shows to his friends and family.
Gastroesophageal Reflux Disease-Related Asthma: Neurogenic Inflammation and Non-pharmacological Management Wibowo, Adityo
Medula Vol 15 No 1 (2025): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v15i1.1540

Abstract

Asthma is a chronic inflammatory disease of the airways, characterized by bronchoconstriction, airway remodeling, and increased responsiveness to non-specific stimuli. While childhood-onset asthma is commonly associated with allergens, adult-onset asthma is linked to environmental and individual factors. One significant contributor to adult-onset asthma is gastroesophageal reflux disease (GERD), which exacerbates asthma symptoms through microaspiration and vagally mediated reflexes. GERD is a chronic gastrointestinal disorder characterized by acid reflux into the esophagus, influenced by factors such as obesity, tobacco use, and stress. Studies indicate a strong association between GERD and asthma, with approximately 80% of asthmatic individuals experiencing heartburn or regurgitation. GERD-induced neurogenic inflammation contributes to airway hyperreactivity and bronchospasm. Non-pharmacological interventions, including dietary modifications, weight loss, smoking cessation, and elevating the head during sleep, have shown efficacy in reducing reflux symptoms and improving asthma control.
Peran Interleukin Pada Mekanisme Imunologis Asma Wibowo, Adityo
Jurnal Kedokteran Universitas Lampung Vol. 8 No. 2 (2024)
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jkunila.v8i2.pp155-161

Abstract

Asma merupakan penyakit kronik saluran napas yang disebabkan inflamasi dan penyempitan saluran napas yang umumnya reversibel. Penyakit ini menyebabkan gejala sesak napas, mengi, batuk, dan rasa berat di dada. Gejala asma dapat bervariasi dari ringan hingga berat, dan seringkali dipicu oleh beberapa faktor internal maupun eksternal. Asma akan menunjukkan gejala utama berupa hiperreaktivitas saluran napas terhadap rangsangan yang masuk seperti alergen, polutan, udara dingindan aktivitas fisik. Obstruksi saluran napas yang muncul pada asma terkait dengan beberapa mekanisme inflamasi kronik dengan keterlibatan berbagai sel. Eosinofil, sel mast, limfosit dan neutrofil menjadi beberapa sel yang diketahui paling sering mempengaruhi derajat berat asma. Namun ternyata mediator inflamasi seperti sitokin memiliki peran yang penting dalam patogenesis asma karena bekerja spesifik sebagai mediator inflamasi dan memengaruhi pembentukan dan pemeliharaan inflamasi, dan menyebabkan eksaserbasi asma. Interleukin sebagai bagian dari sitokin menjadi fokus yang harus diperhatikan fungsinya pada kondisi asma, khususnya asma berat. Kata Kunci : Asma, interleukin, mekanisme imunologi.
Non-surgical Treatment for Recurrent Hemoptysis Due to a Pulmonary Aspergilloma: A Case Report: Adityo Wibowo, Tetra Arya Saputra wibowo, adityo
Jurnal Kedokteran Universitas Lampung Vol. 9 No. 1 (2025): JK UNILA
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jkunila.v9i1.pp91-96

Abstract

Aspergilloma is a distinct form of chronic pulmonary aspergillosis characterized by the formation of a fungal mass composed of living and dead Aspergillus hyphae, inflammatory cells, and tissue debris within preexisting lung cavities. The condition is predominantly caused by Aspergillus fumigatus. Aspergillomas are classified as simple or complex based on cavity wall thickness and surrounding lung parenchyma. Complex aspergillomas develop in thick-walled, fibrotic cavities and present with more severe symptoms, including hemoptysis, chest discomfort, and impaired respiratory function. Although spontaneous resolution occurs in less than 10% of cases, surgical intervention, such as segmentectomy or lobectomy, is indicated for recurrent or life-threatening hemoptysis. Non-surgical options, including antifungal therapy and bronchial artery embolization, may be considered for patients with contraindications to surgery or milder symptoms. Early recognition and appropriate management are essential to reduce morbidity and mortality associated with this potentially life-threatening condition.
Subcutaneous Emphysema Following Chest Tube Insertion in a Patient with Secondary Spontaneous Pneumothorax Due to Chronic Obstructive Pulmonary Disease: A Case Report.: Tetra Arya Saputra, Adityo Wibowo wibowo, adityo
Jurnal Kedokteran Universitas Lampung Vol. 9 No. 1 (2025): JK UNILA
Publisher : Fakultas Kedokteran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23960/jkunila.v9i1.pp28-34

Abstract

Pneumothorax, characterized by the accumulation of air in the pleural cavity and subsequent lung collapse, is a critical clinical entity with significant morbidity, particularly in patients with underlying chronic lung disease such as chronic obstructive pulmonary disease (COPD). Subcutaneous emphysema, although a recognized complication of chest tube insertion, can present diagnostic and management challenges, especially in patients with severe underlying lung disease. We report the case of a 71-year-old male with a history of moderate smoking and untreated COPD who presented with acute worsening dyspnea, pleuritic chest pain, and productive cough. The patient was initially diagnosed with an acute exacerbation of COPD and subsequently developed a left-sided secondary spontaneous pneumothorax, confirmed by chest radiography. Following chest tube insertion, the patient developed extensive subcutaneous emphysema, manifesting as palpable crepitus and swelling extending from the left chest to the neck and abdomen. This case highlights the importance of early recognition and management of pneumothorax and its potential complications in patients with pneumothorax. Subcutaneous emphysema following chest tube insertion can rapidly progress and compromise respiratory function. Awareness of risk factors and vigilant monitoring are essential to optimize outcomes in this vulnerable patient population.
Co-Authors Andreas Makmur, Andreas Apri Lyanda Aryana, Wayan Ferly Azka, Laisa Ekawati, Diyan Faisal Yunus Febrihartati, Isura Gatot Sudiro Hendarto, Gatot Sudiro Gozali, Achmad Indriani, Sri Indah Jordy Oktobiannobel Meirissa, Tria Morfi, Chicy Widia Pinaka Baladika, Dimas Trend Putri, Maharani Rusmini, Hetti Saputra, Tetra Arya Saputra, Tito Tri Simatupang, Elvando Tunggul Mauliate SL, I Made Afryan Soemarwoto, Retno Ariza Soeprihatini Soemarwoto, Retno Ariza Syazili Mustofa Wiwit Ade Fidiawati Zakiah Zakiah