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All Journal Indonesian Journal of Tropical and Infectious Disease Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Respiratory Science Malang Respiratory Journal Indonesian Journal of Cancer
Simatupang, Elvando Tunggul Mauliate
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Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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Silicosis: Mechanisms, Clinical Aspects, and Impacts due to Silica Exposure Esha, Indi; Afdi, Tania Libristina Ambun Suri; Simatupang, Elvando Tunggul Mauliate
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.v44i3.644

Abstract

Silicosis, an occupational lung disease, has significant mortality rates in Indonesia, as reported by Global Health Grove in 2013. The death rate for silicosis stands at 69.3%, with the typical age at death ranging from 40 to 44 years for men and approximately 80 years for women. The pathogenesis of silicosis begins when respirable crystalline silica (RCS) particles enter the airways. These RCS particles bypass the mucociliary defense mechanisms of the respiratory tract and reach the alveoli. Workers frequently exposed to silica are at high risk of developing silicosis, which significantly impacts morbidity and mortality. The diagnosis of silicosis can follow the seven-step principle for determining occupational diseases. Although silicosis is linked to serious conditions such as tuberculosis, autoimmune diseases, and lung cancer, no effective therapy exists. Treatment remains symptomatic, adjuvant, and supportive. To prevent occupational lung diseases, it is essential to involve the government in policy-making for industrial management and workers.
C-Reactive Protein and Procalcitonin as Markers for Post-Bronchoscopic Complications: A Literature Review Indriani, Sri Indah; Yovi, Indra; Syaf, Syarlidina; Simatupang, Elvando Tunggul Mauliate
Jurnal Respirologi Indonesia Vol 44, No 2 (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.v44i2.638

Abstract

In the respiratory system, bronchoscopy is a basic procedure utilized for both diagnostic and therapeutic purposes. Despite being a generally safe procedure, bronchoscopy can result in complications that range in severity from moderate to severe. Pulmonary infection is among the potential complications that can happen after a bronchoscopy procedure. An incidence of 0.2% to 5.2% has been described typically for complications such as empyema, lung abscess, and pneumonia that may develop after bronchoscopy procedures. Although these complications are uncommon, their prognosis can be quite bad. The risk of pulmonary infection, specifically pneumonia, has been related in several studies to sepsis and mortality in patients enduring bronchoscopy procedures. The initiation of the infection exposure process into the lung can be assisted through a variety of factors, including the underlying diagnosis and the type of intervention performed during the bronchoscopy procedure. A critical complication that needs additional consideration is the potential transmission of infection through bronchoscopy procedures. It is beneficial to consider prophylactic antibiotics before a procedure due to the possibility that infectious agents will be transferred from one patient to another. Antibiotic prophylaxis may involve the utilization of C-reactive protein (CRP) and Procalcitonin (PCT) testing as determining parameters. Serial PCT and CRP 24–96 hours post-bronchoscopy procedure might help to determine one of the post-bronchoscopy complications.
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.
The Role of Gut Microbiota as a Trigger for Exacerbations in Pulmonary Obstruction Disorder in General Wijaya, Dewi; Simatupang, Elvando Tunggul Mauliate; Putri, Yolanda Julia Perel; Pratiwi, Adelia; Anggraini, Dewi; Syam, Shaogi
Jurnal Respirasi Vol. 10 No. 3 (2024): September 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.3.2024.257-264

Abstract

Pulmonary diseases can be associated with the gastrointestinal (GI) system, particularly if an infection causes them. This relationship between organs is known as the gut-lung axis (GLA). Skin and mucosal surfaces are associated with microbiota (bacteria, fungi, viruses, macrophages, archaea, protists, helminths), which can trigger an immune response in GLA and serve a role in respiratory diseases. For instance, asthma can be inhibited by a specific antigen that is triggered by probiotics, the microorganisms found in the GI tract. Asthma incidence can be reduced by consuming fiber due to its ability to protect airways from infection. Pattern recognition receptors (PRRs) are the first immune component to identify microbial compounds in GI and lung epithelial cells. The PRRs then induce regulatory T-cell (T-reg) and Th-17 differentiation. Diet, antibiotics, and stress can all influence the structure and function of bacteria. This is known as dysbiosis. Lung microbiota can influence immune cell maturation and homeostasis. If the diversity of lung microbiota decreases, it will affect intestinal microbiota and may result in chronic respiratory disorders such as chronic obstructive pulmonary disease (COPD), asthma, and cystic fibrosis. This literature review explained how the interactions between the intestines and lungs can affect humans’ health and well-being.
Profile of Pulmonary Tuberculosis After COVID-19 at Toba District, North Sumatra Province Simatupang, Elvando Tunggul Mauliate; Simanjuntak, Arya Marganda; Yovi, Indra; Simbolon, Rohani Lasmaria; Fauzi, Zarfiardy Aksa
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.v44i4.716

Abstract

Background: Worldwide cases of pulmonary tuberculosis (PTB) have significantly increased since the COVID-19 pandemic. Indonesia accounted for 6,811,818 of the 767,518,723 cases reported by the World Health Organization. While the Indonesian Ministry of Health reported 824,000 cases, the Global Tuberculosis Report in 2022 reported 10.6 million cases. The pandemic has hampered the goal of eliminating PTB globally, with cases diagnosed after COVID-19 having a 7.15-fold increased risk of contracting the illness.Methods: This cross-sectional study was conducted using total sampling to identify the profile of patients with PTB after having COVID-19 based on age, gender, classification, and type of PTB, as well as the duration of occurrence of PTB after COVID-19. The data collected were from COVID-19 patients from 2020 to 2022, then compared with PTB data. All data were compared to ensure that COVID-19 and PTB patient data were the same.Results: Of the 2544 patients recorded, 29 (1.1%) were infected with PTB after COVID-19 infection. The mean age of patients was 34±18.9 and was dominated by men (68.9%). Most of the cases were drug-sensitive TB (96.6%) and clinically diagnosed TB (55.2%). Age had a statistically significant association with the occurrence of TB cases after COVID-19 infection (P<0.0001). The mean time from the initial diagnosis of COVID-19 to the diagnosis of confirmed TB was approximately 203±34.3 days (6.7 months).Conclusion: After COVID-19, patients have the potential to be infected with TB. Screening former COVID-19 patients can be one solution to finding early cases of PTB.
Profile of Underdiagnosis Lung Cancer with Pulmonary Tuberculosis at Arifin Achmad General Hospital, Pekanbaru Munir, Sri Melati; Aulia, Ananda Febriani; Simatupang, Elvando Tunggul Mauliate; Tanlie, Veghasanah
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1293

Abstract

Background: Lung cancer and pulmonary tuberculosis are respiratory issues that collectively account for the world’s leading cause of mortality. Indonesia, being a nation endemic for Pulmonary Tuberculosis, frequently encounters instances of diagnosis overlap with lung cancer. Delays in the diagnosis of both pulmonary tuberculosis and lung cancer have a global impact on morbidity and mortality. Based on this, this study aims to determine the profile of Lung Cancer patients who were previously diagnosed as pulmonary tuberculosis as an initial diagnosis that can provide new criteria in establishing a diagnosis between pulmonary tuberculosis and lung cancer.Method: This study is a descriptive cross-sectional study using total sampling collected over 1 year. The inclusion criteria were lung cancer patients previously diagnosed with clinical pulmonary tuberculosis, with or without anti-tuberculosis drugs obtained from medical record data. All results are presented in the form of a distribution table. Results: Twenty seven patients diagnosed with adenocarcinoma, with the highest prevalence among males (77.78%). The duration of delay was less than 6 months (62.96%), being the highest rate in this study. Due to the delay in diagnosis, all patients diagnosed with lung cancer were at stage IV. Discussion: Adenocarcinoma is the most common form of lung cancer in men and individuals over 40 years old. Lung cancer with a latency duration of 6 months is typically diagnosed at stage IV. Clinical pulmonary tuberculosis must be investigated further if no clinical improvement is observed after one month of anti-tuberculosis drug treatment.Conclusion: Diagnostic delays of lung cancer significantly impact patient survival. Screening for suspected lung cancer in clinical pulmonary tuberculosis is crucial to reduce morbidity and mortality. Sputum cytology and low-dose CT scan may be utilized as screening modalities.
Diagnosis Approach of Endobronchial Tuberculosis: Literature Review Ginting, Mario Oktafiendi; Indriani, Sri Indah; Simatupang, Elvando Tunggul Mauliate
Indonesian Journal of Tropical and Infectious Disease Vol. 13 No. 1 (2025)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v13i1.60257

Abstract

Pulmonary tuberculosis (PTB) remains a global health problem and the leading cause of death from infectious diseases. Indonesia as an endemic country and the second highest contributor of PTB cases in the world provides support and attention to PTB case finding and treatment success. Endobronchial tuberculosis (EBTB) is problematic PTB because the lesions are often not detected by sputum examination and chest X-ray. Clinically, there is no significant difference in symptoms between TB and EBTB. In general, EBTB gives a more severe clinical appearance due to airway stenosis. Bronchoscopy and thoracic computed tomography scan (CT scan), along with microbiological investigations, are the most useful diagnostic tools for confirming and evaluating tracheobronchial stenosis. In addition, bronchoscopy can also be used as a longterm treatment in cases of EBTB due to airway stenosis. The goals of treatment are the eradication of Mycobacterium tuberculosis (Mtb) bacilli with antituberculosis drugs (ATD) and the prevention of airway stenosis. Intervention of bronchoscopic techniques and surgery are required for those patients who develop severe tracheobronchial stenosis that causes significant symptoms, including dyspnea, repeated post-obstructive pneumonia or bronchiectasis. The most common complications of EBTB are airway stenosis, atelectasis, hemoptysis and shortness of breath accompanied by wheezing despite the administration of ATD. Bronchoscopic intervention can support the acceleration of EBTB treatment, prevent repeated hospitalizations and improve the quality of life of patients. Acceleration of diagnosis and administration of ATDs in a complete and routine way is expected to reduce morbidity and even mortality rates in EBTB cases.
Update on The Current Management of Drug Resistant Tuberculosis (DR-TB) Simbolon, Rohani Lasmaria; Simatupang, Elvando Tunggul Mauliate; Yovi, Indra; Fauzi, Zarfiardy Aksa
Indonesian Journal of Tropical and Infectious Disease Vol. 13 No. 2 (2025)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v13i2.59075

Abstract

Drug-Resistant tuberculosis (DR-TB) is a global public health threat that requires a comprehensive response from all parties. DR-TB cases are often overlooked and tend to increase every year. Efforts to overcome DR-TB cases began in 2009 with the use of a molecular test, Xpert MTB/Rif, as a diagnostic tool. This has now been developed with the procurement of a molecular test with Xpert MTB/XDR. This diagnostic update also formed the basis of the latest DR-TB classification terminology by not categorizing polyresistance into the DR-TB group. This step is still not in accordance with the low success rate of DR-TB treatment in Indonesia, ranging from 45-50%. The latest DR-TB management recommendations by WHO in 2022 have implemented a 6-month treatment regimen to minimize the occurrence of treatment dropout or patient treatment non-compliance. The BPaLM/BPaL regimen is a shorter-duration oral regimen that is expected to help achieve the End TB 2015-2030 targets. Previously used short-term regimens have now been modified with Ethionamide and Linezolid variants as alternatives for DR-TB management if the BPaLM/BPaL regimen does not meet the criteria for use.
Association Between Factory Workers’ Profile with Chest X-ray Finding and Spirometry at Industrial Company of X Wijaya, Dewi; Esha, Indi; Adrianison, Adrianison; Simatupang, Elvando Tunggul Mauliate; Amarudin, Amarudin
Respiratory Science Vol. 6 No. 1 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i1.198

Abstract

Background: Factory workers are a group at high risk of developing occupational lung abnormalities. Continuous exposure to dust, smoke, or gas particles during work processes may lead to progressive lung damage. Chest X-ray and spirometry are essential diagnostic tools for assessing both structural and functional lung changes, allowing early detection and prevention of occupational lung disability, especially among workers exposed to airborne pollutants. Method: This analytical observational study employed a cross-sectional design to analyze the association between factory workers’ profiles and chest X-ray and spirometry findings. Lung function was assessed using spirometry parameters, including Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV₁), and FEV₁/FVC ratio to identify restrictive or obstructive patterns. Data were collected using total sampling during periodic health examinations and analyzed with SPSS version 26.0. Descriptive statistics were used to summarize characteristics, while inferential analysis using Chi-square or Fisher’s exact tests was conducted to determine associations between categorical variables, with a significance level set at P<0.05. Results: A total of 260 factory workers participated, most with ≤5 years of work experience (60.76%). Comorbidities were significantly associated with both chest X-ray findings and lung function (P=0.034 and P=0.004). Smoking history and length of work also showed significant relationships with lung function (P=0.027 and P=0.019). Conclusion: There is a significant association between smoking history and length of work with changes in lung function. Meanwhile, comorbidities have a significant association with lung structure and lung function. Periodic evaluation using spirometry and chest X-ray is essential for early detection and prevention of occupational lung abnormalities among factory workers.
Current Knowledge of Mycobacterium Other Than Tuberculosis (MOTT) in this Current Era: Definition, Taxonomy, and Diagnose Indriani, Sri Indah; Pratiwi, Adelia; Simatupang, Elvando Tunggul Mauliate; Simanjuntak, Arya Marganda
Respiratory Science Vol. 4 No. 3 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i3.122

Abstract

Globally, Pulmonary Tuberculosis (PTB) remains a health concern, with an annual increase in cases. Indonesia is the second-highest contributor to PTB cases globally, below India, which also saw an increase in cases, particularly after the COVID-19 pandemic. Nontuberculous Mycobacteria (NTM) infections contribute to the increase in PTB cases through misdiagnosis and overlapping conditions. The occurrence of changes in the composition of NTM species in the Mycobacterium genus is the premise for updating the diagnosis of NTM with several supporting examination modalities. Clinical, radiological, and microbiological criteria have been established by the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) for the diagnosis of NTM. The relationship between these three criteria is essential as a guideline for distinguishing infections caused by Mycobacterium tuberculosis (Mtb) from those caused by NTM.
Co-Authors Adityo Wibowo, Adityo Adrianison, Adrianison Afdi, Tania Libristina Ambun Suri Amarudin, Amarudin Andreas Makmur, Andreas Aulia, Ananda Febriani Bergant, Briliant Bet, Anwar Dewi Anggraini Esha, Indi Ginting, Mario Oktafiendi Hatta, Hariadi INDRA YOVI Indriani, Sri Indah Pratiwi, Adelia Purnama, Nori Putri, Yolanda Julia Perel Rangkuti, Ina Farida Rohani Lasmaria Simbolon, Rohani Lasmaria Simanjuntak, Arya Marganda Simatupang, Elcia Sri Indriani Sri Melati Munir Syaf, Syarlidina Syam, Shaogi Tanlie, Veghasanah Wijaya, Dewi Wiwit Ade Fidiawati Zarfiardy Aksa Fauzi Zulmaeta