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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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Journal : Medula

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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.
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.
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.
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