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Karakteristik Faal Paru Berdasarkan Pemeriksaan Spirometri pada Pasien Suspek Tumor Paru dan Mediastinum Pratiwi, Suryanti; Agus Setyawan, Ungky; Listyoko, Aditya; Kirana, Intan
Jurnal Klinik dan Riset Kesehatan Vol 1 No 3 (2022): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.01.3.3

Pendahuluan: Keganasan paru merupakan penyakit paru yang memiliki tingkat kematian tertinggi di dunia. Pemeriksaan untuk mengetahui fungsi paru dengan menggunakan spirometri. Tujuan: Penelitian ini bertujuan untuk mengetahui distribusi faal paru pasien dengan diagnosis suspek tumor paru dan mediastinum di Rumah Sakit Saiful Anwar (RSSA) Malang berdasarkan usia, jenis kelamin, indeks massa tubuh (IMT), dan diagnosis. Metode: Penelitian deskriptif analitik, pendekatan cross-sectional dengan menggunakan data rekam medis Januari 2018 – Desember 2019 kemudian dilakukan uji spearman. Hasil: Hasil penelitian menunjukkan diagnosis suspek tumor paru dan mediastinum paling banyak pada rentang usia 51-60 tahun, jenis kelamin terbanyak laki-laki, diagnosis terbanyak tumor paru. Hasil interpretasi pemeriksaan spirometri terbanyak menunjukkan restriksi, dan IMT normal. Hasil analisis hubungan gambaran faal paru memiliki p-value pada suspek tumor paru dan mediastinum (0,814), jenis kelamin (0,003), dan IMT (0,360). Kesimpulan: Terdapat hubungan yang signifikan antara gambaran faal paru dengan jenis kelamin dan tidak didapatkan hubungan yang signifikan antara gambaran faal paru dengan diagnosis dan IMT.

THE RELATIONSHIP BETWEEN THE LEVEL OF KNOWLEDGE ABOUT THE DANGERS OF CIGARETTES AND CARBON MONOXIDE LEVELS OF BREATHING AIR IN STUDENTS FROM A HIGH SCHOOL IN MALANG Dwi Pratiwi, Suryanti; Agus Setyawan, Ungky; Mafisah, Saidah; Muhammad, Iqbal; Herda Asyari, Claudia; Dini, Zata; Pratiwi, Eka; Lyono, Albert; Delfianto, Dwiroza Delfianto; Nur Hikmah, Naila Nur Hikmah; Suardana, I Made Suardana; Martha , Martha
Journal of Community Health and Preventive Medicine Vol. 4 No. 2 (2024): JOCHAPM Vol. 4 No. 2 2024
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jochapm.2024.004.02.3

This study aims to analyze the relationship between the level of knowledge about the dangers of smoking and smoking behavior and exposure to cigarette smoke in high school students. This quantitative descriptive research with a cross-sectional design involved 114 students from one Malang Senior High School, with sampling using a simple random sampling method. Using a CO analyzer, data was collected through questionnaires to measure students' knowledge levels and measurements of carbon monoxide (CO) in breathing air. The study results showed that 62% of the respondents were women and 38% were men, with an average age of 16.8 years. As many as 80% of students do not smoke, while the other 20% are active smokers. The average CO level of the students' breath air was 3.34 PPM, with active smokers showing significantly higher CO levels (7.74 PPM) compared to passive smokers (2.06 PPM) and non-smoking students (2.61 PPM). The ANOVA statistical test showed a significant difference in CO levels between groups (p < 0.05). Although the level of students' knowledge about the dangers of smoking was relatively high (average pretest 124), no significant relationship was found between knowledge and smoking behavior (p = 0.802). The study concluded that although knowledge about the dangers of smoking is moderate, smoking behavior among male students remains high, suggesting the need for more in-depth interventions to address the social and psychological factors that support smoking behavior.

Progression Free Survival pada Pasien Kanker Paru Adenokarsinoma Wild Type dengan Kombinasi Regimen Pemetrexed dengan Cisplatin dibandingkan dengan Karboplatin Agus Setyawan, Ungky; Purnamawati, Catur; Pratiwi, Suryanti
Jurnal Klinik dan Riset Kesehatan Vol 4 No 2 (2025): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.2.2

Pendahuluan: Progression-free survival (PFS) adalah parameter untuk mengukur perkembangan kanker paru adenokarsinoma wild type. Berbagai studi literatur telah menunjukkan bahwa kombinasi kemoterapi berbasis platinum-pemetreksed lebih efektif untuk progresivitas adenokarsinoma wild type yang berkepanjangan. Tujuan: Tujuan penelitian ini membandingkan PSF pasien adenokarsinoma wild type yang mendapat rejimen sisplatin-pemetreksed dan karboplatin-pemetreksed di Rumah Sakit Dr. Saiful Anwar tahun 2018-2021. Metode: Penelitian kohort retrospektif berdasarkan medical record pasien adenokarsinoma wild type. Hasil: Hasil penelitian menunjukkan bahwa pemberian rejimen karboplatin-pemetreksed memiliki PFS yang lebih panjang (median 4 bulan, 95% CI 2.657-5.343) dibandingkan dengan sisplatin-pemetreksed (median 2 bulan, 95% CI 0.988-3.012). Selain itu risiko progresivitas kanker paru berdasarkan PFS tidak dipengaruhi secara signifikan oleh nilai skala Karnofsky 70-80 (72,2%, HR 0,278). Sebaliknya, riwayat merokok meningkatkan risiko progresivitas kanker paru, walaupun tidak berpengaruh secara signifikan (HR 1.538). Kesimpulan: Pemberian rejimen karboplatin-pemetreksed memperpanjang PFS hingga 10-16 bulan, meskipun tidak ada perbedaan yang signifikan secara statistik bila dibandingkan dengan sisplatin-pemetreksed.

Karakteristik Faal Paru Berdasarkan Pemeriksaan Spirometri pada Pasien Suspek Tumor Paru dan Mediastinum Pratiwi, Suryanti; Agus Setyawan, Ungky; Listyoko, Aditya; Kirana, Intan
Jurnal Klinik dan Riset Kesehatan Vol 1 No 3 (2022): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.01.3.3

Background: Lung malignancy is a lung disease that has the highest mortality rate in the world. An examination to determine the state of lung function is spirometry. Aim: This study aims to determine the distribution of lung function in patients with suspect of lung and mediastinal tumor at Saiful Anwar Hospital Malang based on age, sex, body mass index (BMI), and diagnosis. Methods: This research is a descriptive analytic, cross-sectional approach using medical record data from January 2018 to December 2019 and then the data would be processed by spearman test. Results: The results showed that patients with suspect lung and mediastinal tumors suffered the most in the age range of 51-60 years, the sexes were mostly male, the most diagnoses were lung tumors. Most of the interpretation results of the spirometry examination showed restriction, and normal body mass index. The results of the analysis of the relationship between pulmonary function descriptions had a p-value of 0.814 for diagnosis of suspected lung and mediastinal tumor, 0.003 for gender, and 0.360 for BMI. Conclusion: It can be concluded that there is a significant relationship between pulmonary function and gender and there is no significant relationship between pulmonary function with the diagnosis and BMI.

Progression Free Survival pada Pasien Kanker Paru Adenokarsinoma Wild Type dengan Kombinasi Regimen Pemetrexed dengan Cisplatin dibandingkan dengan Karboplatin Agus Setyawan, Ungky; Purnamawati, Catur; Pratiwi, Suryanti
Jurnal Klinik dan Riset Kesehatan Vol 4 No 2 (2025): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.2.2

Background: Progression-free survival (PFS) is a parameter to measures the progression of wild type adenocarcinoma lung cancer. Literature studies have shown that the combination platinum based-pemetrexed chemotherapy is more effective to prolonged progressivity of wild type adenocarcinoma. Aim: The aim of study to compared the PSF of wild type adenocarcinoma patients receiving cisplatin-pemetrexed and pemetrexed-carboplatin regimens at Dr. Saiful Anwar Hospital in 2018-2021. Methods: A retrospective cohort study based on medical record of wild type adenocarcinoma patients. Results: The results showed that the administration of a carboplatin-pemetrexed regimen has prolonged PFS (median 4 months, 95% CI 2.657-5.343) compared to the cisplatin-pemetrexed regimen (median 2 months, 95% CI 0.988-3.012). In addition, the risk of lung cancer progression based on PFS is not significantly influenced by the Karnofsky scale value of 70-80 (72.2%, HR 0.278). On the other hand, a history of smoking increases the risk of lung cancer progression, although it does not have a significant effect (HR 1,538). Conclusion: Administration of the carboplatin-pemetrexed regimen prolongs PFS up to a range of 10-16 months, although there is no statistically significant difference compared to the cisplatin-pemetrexed.

Rare Case: 65 Year Old Man with Anteromedial Mediastinal Tumor (Thymic Carcinoma) Mimicking Lung Cancer Lyono, Albert; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Isharanto, Artono
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.02

Background: Thymic carcinoma are very rare and often accompanied by metastases to other organs, pericardial effusion and pleural effusion where the 5-year survival rate is about 55%. Thymic carcinoma has several subtypes, squamous cell carcinoma and undifferentiated carcinoma. Case Report: A 65-year-old man coincidentally showed a mediastinal tumor on CXR while infected with COVID-19. Spirometry shows mild obstruction and restriction. Thorax CT scan suggests an anterior-middle mediastinal mass with left pleural effusion. The patient underwent a core biopsy followed by VATS tumor excision. Immunohistochemistry CK(+) and Vimentin(-) suggest a solid type adenocarcinoma, then Napsin A(-), TTF1(-), P40(+) suggest squamous cell carcinoma. The patient was diagnosed with left anteromedial mediastinal tumor (Thymic carcinoma: Squamous cell carcinoma) Masaoka stage III, left pleural effusion. The patient was treated with first line chemotherapy Carboplatin-Etoposide 6 series resulting stable disease followed by maintenance chemotherapy etoposide 6 series. The last RECIST suggests a solid malignant mass in the left lung (stable disease). Discussion: Surgery with radiotherapy is treatment for resectable cases but for unresectable cases chemotherapy with or without radiotherapy is preferred. The patient was unresectable case treated with chemotherapy. Thymic carcinoma has a poor response to chemotherapy with overall response rate around 22-36% but this patient has stable disease with chemotherapy. Conclusion: 65 years-old man without respiratory complaints diagnosed with unresectable thymic carcinoma and left pleural effusion, underwent chemotherapy with result stable disease up to 9 months continued maintenance therapy and become a resectable tumor. Keywords: Thymic carcinoma, Squamous Cell Carcinoma

Rare and challenging case: a young woman with a pulmonary malignant peripheral nerve sheath tumor mimicking mesothelioma Irawan, Ari; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Setyo Yudhanto, Hendy; Kusuma Wardhana, Koernia; Rachma Erawati, Dini
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.03

Introduction: Malignant peripheral nerve sheath tumor (MPNST) is a rare and highly aggressive tumor that develops from peripheral nerves which is closely related to neurofibromatosis type 1 (NF1). It has a very small percentage of occurrence in the lung. Here, we would like to report a case of pulmonary MPNST mimicking mesothelioma that was treated with cisplatin-pemetrexed. Case Illustrations: A 17-year-old female with no history of NF1, complaints of shortness of breath, and weight loss. A thoracic CT-scan and pathology were initially consistent with suspected mesothelioma. A unique finding in this case, was demonstrated positive vimentin and CD56, also loss of nuclear SOX10 and H3K27me3 expression in spindle cells. After a multidisciplinary board discussion, the diagnosis of MPNST was assumed. She underwent a palliative chemotherapy regimen. Discussion: Pulmonary MPNST with or without NF1 seems infrequent. Its clinical findings are usually nonspecific with a complex histological appearance. Establishing the diagnosis of MPNST is challenging, therefore pathological examination and immunohistochemistry (IHC) become the gold standard. The expression of SOX10 has poor sensitivity, also the loss of S100 expression may indicate de-differentiation of Schwann cells, hence, it may be less specific for MPNST diagnosis. Nevertheless, the loss of H3K27me3 marker has a great diagnostic value. The most effective treatment is complete surgical resection to achieve negative margins. However, in our case, the tumor has metastasized and is unresectable, so she was treated with the cisplatin-pemetrexed chemotherapy regimen and obtained stable disease results on the RECIST-CT examination after 3-series-chemotherapy. Conclusion: MPNST is a rare case with difficulties in diagnosis due to nonspecific clinical and histological features, therefore, IHC plays an important role in providing its diagnosis. Chemotherapy might be a good approach for treating an unresectable MPNST, but, still, there is no gold standard for palliative care guidelines.

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