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Giant Intrapulmonary Mature Teratoma with Thoracostomy Intervention: A Rare Case Report Indriani, Sri Indah; Simatupang, Elvando Tunggul Mauliate; Bergant, Briliant; Makmur, Andreas; Rangkuti, Ina Farida
Malang Respiratory Journal Vol. 6 No. 1 (2024): March 2024 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.01.06

Abstract

Background: Teratoma usually found in mediastinum and rarely found in the lung. Mature teratomas are the most common histological type of germ cell tumours, followed by seminoma. First case reported by Mohr in 1839 and until now only few cases of intrapulmonary teratomas have been reported. Case: A man, 64-years old man, nonsmoker complains of shortness of breath since 6 months and worsened in a week. Patient had history medication for tuberculosis in 2019. Chest Contrast CT-Scan showed hypodense mass and suggestive for benign left lung tumor. TTNA were performed and suggestive for teratoma. Joint conference with several department agree to proceed with thoracostomy. Thoracostomy with wide excision been done to remove the mass and examined for anatomic pathology then confirmed for mature teratoma. During thoracostomy, we cannot removed 100% of the tumor because it adhesive with aorta and parietal pleura. Patient treated in ICU and worsens. Unfortunately, patient passed away four days later. Conclusion: Teratoma is rarely found inside of the lung. Early diagnosis and resection of intrapulmonary teratoma is critical to prevent complications and provide definitive treatment.
Overlapping of Intestinal Tuberculosis with Typhoid Fever as Initial Diagnosis: A Case Report Simatupang, Elvando Tunggul Mauliate; Simbolon, Rohani Lasmaria; Bet, Anwar; Makmur, Andreas; Simatupang, Elcia
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.03

Abstract

Background: Extrapulmonary Tuberculosis (ETB) cases have increased to 20-30% of all Pulmonary Tuberculosis (PTB) cases, including Intestinal Tuberculosis (ITB). Overlap between ITB and Typhoid Fever (TF) leads to Diagnostic Delays in ITB. Endoscopic and histopathological examinations are needed as diagnostic support, so comprehensive examination and clinical evaluation are necessary. Accurate diagnosis and management will have significant implications for patient survival. Case: A 23-year-old male patient complained of shortness of breath for three weeks. Previously fever, night shivering, loss of appetite, and weight loss were also experienced. A history of previous hospitalization involving abdominal colic complaints, the patient should be hospitalized twice. Repeated administration of antibiotics with TF diagnosis did not show any clinical improvement. The suspicion of ITB was proven after obtaining positive results from Genexpert (GE) of Faeces and clinical response after Anti Tuberculosis Drugs (ATD) administration. Overall, there were clinical, laboratory and radiological improvements in patients with clinical abdominal colic and fever experienced in the last 2 months. Conclusion: Challenge ATD delivery and GE of Faeces can be used as an indicator of suspects ITB so overlap between ITB and TF can be predicted. A comparative diagnostic study of abdominal colic and recurrent fever should also be extended so that it can be continued with several diagnostic support.
Successful Autologous Blood Patch Pleurodesis: A Safe and Useful Treatment for Persistent Pneumothorax in Former Pulmonary Tuberculosis and Aspergillosis in Pregnant Women Purnama, Nori; Simatupang, Elvando Tunggul Mauliate; Fauzi, Zarfiardy Aksa; Indriani, Sri; Yovi, Indra; Hatta, Hariadi; Zulmaeta
Malang Respiratory Journal Vol. 6 No. 1 (2024): March 2024 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.01.04

Abstract

Background: Autologous Blood Patch Pleurodesis (ABPP) is one of the treatment options for persistent pleural air leaks especially in patients who are not suitable for surgical intervention. Persistence pneumothorax is defined as pneumothorax of more than five days duration. It is associated with increased morbidity and cost of care. The most widely accepted treatment for it is pleurodesis. Several types of pleurodesis have been proposed, including surgical approaches and the instillation of different chemicals in the intrapleural space. ABPP has proven to be a simple, inexpensive, efficacious and safe method. We present the case of the first patient with Persistent Pneumothorax we have treated Successfully with ABPP. ABPP is currently rarely and uncommonly used, but it provides benefits especially in special conditions with easier, cheaper, and quite effective procedures. Case: A female 35-year-old pregnant women patients with Former Tuberculosis (FTB) come to our hospital with complaints breathlessness and chest pain worsening since 3 days before admitted to our hospital. Chest radiography showed spontaneous pneumothorax with GeneXpert (GE) sputum Mtb Not Detected but there is Aspergillosis from Fungal Culture. Water Sealed Drainage (WSD) was inserted in right pleural for almost 1 month and this patient discharge with pneumostat. One month after that she come again with Persistence Pneumothotax, so that we do the pleurodesis with Blood Patch and get the improvement from clinical status. Antifungals are continued for an initial 4-6 weeks while an outpatient evaluation is conducted. Conclusion: ABPP is a safe, inexpensive and efficacious treatment for persistent pleural air leak. Autologous Blood Patch administration may be considered for patients with Persistent Pneumothorax.
Update on the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2023) Adrianison, Adrianison; Simbolon, Rohani Lasmaria; Simatupang, Elvando Tunggul Mauliate
Jurnal Respirologi Indonesia Vol 44 No 1 (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.v44i1.451

Abstract

The overall increase in morbidity and mortality associated with chronic obstructive pulmonary disease (COPD) is inextricably linked to the concept of Global Initiative for Chronic Obstructive Lung Disease (GOLD) updates. An element of every GOLD update is directed toward policymakers, healthcare professionals, and people in general in order to evaluate the immediate and prolonged consequences of COPD. At this time, international interest is focused on the acceleration of the GOLD 2022 update to GOLD 2023 in an effort to enhance clinical management approaches for COPD, including individualized and comprehensive COPD treatment. The GOLD 2023 update will encompass the following aspects: definition and taxonomy, screening and case identification, diagnosis pathway, pharmacological and non-pharmacological approaches to managing stable COPD, and exacerbation management, as discussed in this review. GOLD 2023 explains that the diagnosis of emphysema has been classified as a pathologic diagnosis, in comparison with GOLD 2022. In the meantime, the clinical and epidemiological diagnosis of COPD is chronic bronchitis. The risk factor for tobacco smoke, which was once thought to be the primary cause of COPD, is described in GOLD 2023, together with the most recent taxonomy that has been developed to identify additional contributing components. The word "GET", which refers to the interaction of three risk factors-gene (G), environment (E), and lifetime (T)-that can cause lung damage and accelerate the aging or development of the lungs, is also linked to the most recent taxonomy of COPD. The switch from the "ABCD" approach to the "ABE" method for diagnosis and management of stable COPD is another significant modification included in the GOLD 2023 update. The number of COPD cases worldwide is expected to rise in the upcoming years as an outcome of long-term exposure to risk factors. Consequently, with the goal of increasing patient survival rates, GOLD 2023 highlights the significance of screening and early case discovery through the provision of non-pharmacological care.
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.
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.
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.
Bagaimana Bekas Tuberkulosis Dapat Menginduksi Kanker Paru? Simatupang, Elvando Tunggul Mauliate; Simanjuntak, Arya Marganda; Yovi, Indra; Simbolon, Rohani Lasmaria; Munir, Sri Melati; Wijaya, Dewi
Majalah Kedokteran Indonesia Vol 73 No 6 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.6-2024-1087

Abstract

In 2022, there will be 10.6 million cases of tuberculosis, which is a serious problem worldwide. Thailand's cohort research after the COVID-19 pandemic found a 7-fold risk of tuberculosis infection in COVID-19 patients, pointing to a probable rise in TB cases. In order to completely eradicate TB, care must be given to patients both before and after infection, guaranteeing public health against TB infection.1,2
Lung–Kidney Interactions: Impact for Systemic Disease Simatupang, Elvando Tunggul Mauliate; Wijaya, Dewi; Sembiring, Ligat Pribadi
Respiratory Science Vol. 6 No. 2 (2026): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i2.199

Abstract

Lung–kidney interaction is increasingly recognized as an important determinant of prognosis in systemic and critical illnesses. This is physiologically based and often occurs in daily medical practice. Evidence shows that dysfunction in one organ may trigger or worsen injury in the other, making this relationship relevant in clinical assessment and therapeutic decision-making. Understanding this bidirectional interaction is essential, as it influences disease severity, treatment response, and mortality. Direct or indirect, lung–kidney interactions are frequently observed in clinical practice. Hypercapnia, hypoxemia, and systemic inflammatory response are among many factors that can induce renal involvement in lung disease. Between lung complications and kidney function abnormalities, there is a correlation, such as pulmonary edema, pleural effusion, chronic kidney disease and acute kidney injury. The patients of acute kidney injury and chronic kidney disease may be more susceptible to lung issues due to several internal risk factors, including uremia, metabolic acidosis, electrolyte imbalances, and volume overload or increased fluid volume. Other external risk factors that also contribute to lung issues include systemic inflammation and oxidative stress. Occupational and environmental exposures may also contribute to lung disease, and indirectly accelerate renal function decline.  Despite clinical relevance, lung–kidney interactions remain underrecognized in autoimmune diseases.