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INDONESIA
Jurnal Respirologi Indonesia
Published by Perhimpunan Dokter Paru Indonesia
ISSN : 08537704     EISSN : 26203162     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Jurnal Respirologi Indonesia (JRI) is an online and printed scientific publication of the Indonesian Society of Respirology (ISR). The journal is published thrice-monthly within a year (January, April, July and October). The journal is focused to present original article, article review, and case report in pulmonary and critical care medicine.
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Articles 12 Documents
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Search results for , issue "Vol 44, No 1 (2024)" : 12 Documents clear
Bacterial Profile and Antimicrobial Resistance Patterns of Pleural Empyema in Pekanbaru Hospitals Yovi, Indra; Safari, Dodi; Syah, Nur Afrainin; Anggraini, Dewi; Hanifah, Zulfa Nur; Shapira, Vanesya Zahrani; Elliyanti, Aisyah
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.v44i1.590

Abstract

Background: Empyema is a problem worldwide due to its high incidence, mortality, and morbidity rates. So, administering antibiotics is mandatory to treat the disease. It should be sensitive to the causal microorganisms and avoid resistant ones for treatment efficacy. This research aimed to determine bacterial profile and antimicrobial resistance, which can be fundamental foundations for clinical practices in the treatment of patients, especially in Pekanbaru.Methods: This was a cross-sectional study from medical records at Arifin Achmad and Eka Hospitals from January 1, 2015, to December 31, 2022, including culture and antibiotic resistance test results with samples from pleural fluid and antibiotic susceptibility test using VITEK 2.0.Results: A total of 197 pleural fluid specimens were obtained. Gram-negative bacteria were found to be the most prevalent at 79.7%, namely Klebsiella pneumoniae (18.5%), Escherichia coli (12.0%), and Pseudomonas aeruginosa (11.0%). Gram-positive bacteria were found at 12.2%, the most common being Staphylococcus aureus (6.1%) and Enterococcus faecalis (2.0%). Antibiotic sensitivity tests for Gram-negative bacteria showed that amikacin and tigecycline were the most sensitive, and Gram-positive bacteria showed the most sensitivity to linezolid, tigecycline, and vancomycin. The resistance of Klebsiella pneumoniae and Escherichia coli to cephalosporins was 18.5% and 75.0%, respectively. The resistance of Klebsiella pneumoniae, Escherichia coli, and Pseudomonas aeruginosa to carbapenems was 8.0%, 13.0%, and 53.0%, respectively.Conclusion: Gram-negative is the most common microorganism found in pleural empyema. The resistance of multiresistant bacteria to antibiotics is high and requires supervision to apply appropriate antibiotic administration based on local antimicrobial patterns and the need to strengthen antimicrobial stewardship programs. 
The Overview Side Effects of MDR TB Short Term Regimen for Heart and Kidney Function in MDR TB Patients at H. Adam Malik General Hospital Medan, North Sumatra Diana Santy; Parluhutan Siagian; Bintang YM Sinaga; Putri C Eyanoer
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.v44i1.573

Abstract

Background: World Health Organization issued a recommendation for the use of standard 9–11 month Shorter Multidrug-Drug Resistant Tuberculosis (MDR TB) regimen. It will impact the number of patients treated and improve obedience because of the shorter, low cost, and well-tolerated. However, MDR TB drugs allow side effects both mild, moderate and severe. If severe side effects occur, the patient will stop treatment and close monitoring required. An optimal and adequate care of side effects is the key of the successful of MDR TB treatment. The aim of this study was to determine the side effects that occured in the treatment of MDR TB patients with short term regimen (STR) on heart and kidney function at H. Adam Malik General Hospital Medan, North Sumatra.Methods: A case series design with a total of 76 MDR TB patients who underwent a shorter regimen. Samples were obtained from the medical record in the pulmonary isolation inward and MDR TB polyclinic at Adam Malik Hospital, Indonesia. Data were analyzed descriptively to identify changes in heart (Prolong QTc) and kidney function of the nine months treatment.Results: 76 data were collected, the number of male samples was 68.4% and 31.6% were women with the age group of the study subjects being mostly followed by 41-50 years of age. There was a significant increase in value occurred in 4-6 months of treatment related to the side effects of treatment on heart (Prolong QTc) and kidney function.Conclusion: There was a trend to increase the value of heart (Prolong QTc) and kidney function significantly occurred 4-6 months after the patient underwent MDR TB treatment with STR.
Krebs von den Lungen-6 (KL-6) and Surfactant-D as Biomarkers of Interstitial Lung Disease: A Literature Review Fanny Fachrucha; Muhamad Rizqy Fadhillah; Syazatul Syakirin Sirol Aflah
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.v43i4.439

Abstract

Interstitial Lung Disease (ILD) is a group of lung diseases characterized by various patterns of lung tissue damage, including inflammation and fibrosis of the lung interstitium, both with known or unknown causes (idiopathic). In establishing the diagnosis of ILD, a comprehensive approach including history-taking, physical examination, and supporting examinations, is needed and managed in a multidisciplinary manner. Biomarkers are diagnostic tools known to be accessible, inexpensive, reproducible, and non-invasive for helping diagnose ILD patients. Growing evidence has supported the idea that many biomarker molecules can detect lung injury in ILD, including Krebs von de lungen-6 (KL-6) and Surfactant D (SP-D). KL-6 and SP-D could be utilized in the detection, disease monitoring, prognostication, and therapeutic responses of ILD patients. This review aimed to discuss several potential Kl-6 and SP-D biomarkers against ILD and discusses their clinical utility.
The 4T Approach for Smoking Cessation Compliance for Pulmonary Tuberculosis Patients in Persahabatan Referral Hospital Septauli, Kolanda Maria; Susanto, Agus Dwi; Agustin, Heidy; Ginting, Tribowo Tuahta; Taufik, Feni Fitriani
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.v44i1.578

Abstract

Background: Smoking increases the risk of tuberculosis infection and affects its treatment success rate and mortality. Most TB patients who smoke quit at the initial diagnosis, but may continue to smoke if the clinical symptoms improve. Studies show that the 4T approach (Tanya, Telaah, Tolong nasehati, and Tindak lanjut) helps smokers quit. The 4T approach was applied in Indonesia as a smoking cessation program for TB patients.Methods: We conducted a randomized controlled trial on 43 male TB patients who smoke. The trial group received a 4T approach consisting of education, counseling, and motivation to quit smoking for three months. The control group received a self-help leaflet. Smoking status, Fagerström nicotine dependence scale, exhaled carbon monoxide level, and peak expiratory flow rate were collected. We observed the subjects at months 1, 2, and 3 after quitting smoking and reported on the Motivation and Minnesota Withdrawal Scale.Results: Smoking cessation levels during months I, II, and III (Continuous Abstinence Rate I, II, and III) were higher in the trial group than in the control group. The trial group had a higher percentage of smoking cessation than the control group: until 4 weeks (66.7% vs. 54.5%), until 8 weeks (57.1% vs. 45.5%), and until 12 weeks (52.4% vs. 45.5%). The control group had higher numbers of smoking relapses (18.2% vs. 14.3%) and still smokers (18.2% vs. 9.5%) after the study. Withdrawal symptoms included an increase in appetite (44.1%), cigarette cravings (6.9%), agitation (2.3%), insomnia (2.3%), and irritability (2.3%). There were no significant differences in the withdrawal scale between groups (P=0.788), but the trial group showed better motivation to stop smoking during CAR II (P=0.043).Conclusion: The 4T approach is effective in maintaining abstinence from smoking among lung tuberculosis patients until months 1, 2, and 3 after quitting. Smoking cessation programs during tuberculosis treatment can help patients quit smoking and reduce relapse.
Association between Smoking Habits and Outcomes of COVID-19 Patients in Persahabatan Hospital, Jakarta Ayesya Nasta Lestari; Feni Fitriani Taufik; Agus Dwi Susanto
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.v44i1.600

Abstract

Background: : Factors related to the severity and the outcome of coronavirus disease 2019 (COVID19) are emerging subjects of interest to be studied. Smoking has long been known to have a negative impact on the response to infection. The purpose of this study was to determine the association between smoking habits with the severity, the length of hospitalization and the outcome of COVID19 patients.Methods: This study was a prospective cohort study of COVID-19 patients admitted at Persahabatan Hospital, Jakarta, Indonesia. Subjects were included by consecutive sampling from August to October 2021. Subjects were assigned into smokers and non-smokers group. All subjects were assessed for their severity, length of hospitalization and outcome; in smoking patients, the Brinkman Index (IB) and the Fagerström Test for Nicotine Dependent (FTND) score were also recorded. Statistical tests were then carried out to assess the significant association between smoking history and the degree of severity, length of hospitalization and outcome of COVID-19 in all patients and the FTND and IB scores with the degree of severity, length of hospitalization and outcome of COVID-19 in smokers.Results: Authors found that 39/100 (39%) of participants were smokers. Smoking history had a correlation with the outcome (p=0.001) but not with the degree of severity (p=0.410) and length of hospitalization (p=0.780). Among subjects with smoking history, there were correlations found between FTND and the degree of severity and the outcome (p=0.022 and p=0.012), but not with the length of hospitalization (p=0.716). The Brinkman Index was correlated with only the degree of severity (p=0.020).Conclusion: Our study found that smoking habits were correlated with the degree of severity and outcomes in COVID-19 patients.
Duration of Hospitalization and Risk Factors of Readmission of Community-Acquired Pneumonia Incidence in Hospitalized Toddlers Corina Lisa; Merita Arini
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.v44i1.560

Abstract

Background: The Indonesia Health Profile Report 2020 stated that pneumonia is one of the causes of high infant and toddler mortality in Indonesia. Length of stay and readmission are crucial indicators of service quality for hospitalized pneumonia patients. This study aims to determine the duration of hospitalization and identify risk factors for readmission among toddlers hospitalized with CAP.Methods: This cross-sectional study was conducted with subjects of pneumonia toddlers hospitalized in Sarila Husada Hospital Sragen from November 2021 to Januari 2023Results: A total of 357 toddlers were hospitalized with CAP (median age = 17 months; IQR 7–24); the majority were under 36 months old (309 subjects; 86%); male (54%) predominated than female (46%). Median duration of hospitalization for CAP=2 days with IQR=3.0-5.0. Readmission events were only 5, higher among toddlers aged 2-36 months but not statistically significant. Factors associated with readmission in CAP toddlers were the history of previous hospitalizations during the past year due to infection (P=0.012; adjusted odds ratio [aOR]=13.6; confidence interval [CI]=1.49–12.34).Conclusion: The readmission rate was very low in our study. Toddlers 2–36 months of age and those with previous hospitalizations with infections are at higher risk of readmission in CAP.
Association Between Ferritin Levels and Sepsis in Patients with COVID-19 at Dr. M. Djamil Hospital Diana Nur Asrini; Oea Khairsyaf; Afriani Afriani
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.v44i1.545

Abstract

Background: Ferritin is an important mediator of immunomodulatory dysregulation and pro-inflammatory effects, which contribute to cytokine storms that could lead to sepsis in a critically ill patients with COVID-19. The role of ferritin as a biomarker of sepsis in those patients is yet fully understood. The aim of this study is to investigate an association between ferritin levels and sepsis in patients with COVID-19.Method: This study was a retrospective, cross-sectional study of 474 COVID-19 hospitalized patients at Dr. M. Djamil Hospital, Padang.Result: Most of the COVID-19 patients in this study were between the ages of 18 and 49 (38,61%), female (55.91%), with moderate clinical illness (40.50%), and had one comorbidity (41,14%) with obesity as the most common comorbidity (37.97%). More than half of patients (54,22%) had ferritin levels of ≥500 ng/mL (median 1,201 ng/mL with a range of 503–12,010 ng/mL). The incidence of sepsis was significantly higher in the group whose ferritin level was ≥ 500 ng/ml compared to those with less ferritin level (P<0.001; OR=3.33; 5.99% vs 17.91%; CI 95%=1.74-6.36).Conclusion: There is a statistically significant association between the ferritin level and sepsis in patiens with COVID-19 at DR M Djamil Hospital.
Update on the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2023) Adrianison Adrianison; Rohani Lasmaria Simbolon; Elvando Tunggul Mauliate Simatupang
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.
Comparison of NEWS, SIRS, and qSOFA Score as Predictors of Mortality and Length of Stay in Patients Pneumonia with Sepsis Harsini Harsini; Aditya Alfarizi; Jatu Aphridasari; A Farih Raharjo; Reviono Reviono
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.v44i1.505

Abstract

Background: Pneumonia is a major health problem in all age groups and often related with sepsis. In 2021, Surviving Sepsis Campaign Guidelines mentioned several clinical scoring systems to identify patients with potentials of developing sepsis, such as systemic inflammatory response syndrome (SIRS), national early warning score (NEWS), quick sequential organ failure assessment (qSOFA) and sequential organ failure assessment (SOFA). The guideline stated that there is no gold standard for diagnosing sepsis, contradicting The Sepsis-3 Guideline in 2016 that mentioned SOFA score as a gold standard for diagnosing sepsis.Methods: Subjects were all patients with pneumonia and sepsis who were treated in Dr.Moewardi Hospital within 1 January to 31 December 2022. Data from subjects’ medical records were collected to assess their NEWS, SIRS, qSOFA, and SOFA score on the day of admission. Since evaluation of SOFA score needs a number of components requiring laboratory results and takes longer time so they made a simpler tool called qSOFA to avoid delayed treatment of the patients.Results: NEWS is more consistent with SOFA compared to SIRS and qSOFA (Kappa value = 0.726 vs 0.320 vs 0.22; respectively). NEWS, SIRS, and qSOFA were all significantly correlated with mortality (P<0.001) with NEWS having the strongest correlation (r=0.482 vs 0.216 vs 0.175; respectively). Only NEWS showed significant correlation with the length of stay (r=0.129; P<0.001).Conclusion: NEWS was the most consistent score to SOFA compared to SIRS and qSOFA. NEWS was also the best predictor for mortality and was the only score correlated with length of hospital stay.
The Role of Omega-3 on the IL-6 Levels, Malondialdehyde, and Clinical Improvement in Adults with Community-Acquired Pneumonia Dewi Astarini; Jatu Aphridasari; Ana Rima Setijadi
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.v44i1.402

Abstract

Background: Acute lung parenchymal infection, known as pneumonia, can be carried on by multiple microorganisms, including bacteria, viruses, fungi, and parasites. Globally, community-acquired pneumonia is a major factor of morbidity, mortality, and health issues. Malondialdehyde (MDA) is a marker of oxidative stress in pneumonia patients, and interleukin 6 (IL-6) is a marker of inflammatory process. Effect of Omega-3 as an immunomodulator, anti-inflammatory, and antioxidant may be implemented as adjunctive therapy in patient with community-acquired pneumonia.Methods: Clinical trial research with a true experimental method and pretest-posttest design. The study involved 30 community-acquired pneumonia patients who were admitted at Moewardi Hospital in Surakarta and Dr. Soehadi Prijonegoro Hospital in Sragen from August to September 2022 by consecutive sampling. The control group (n=15) received standard therapy, and the treatment group (n=15) received standard therapy plus Omega-3 at a dose of 1600 mg/day. IL-6 and MDA levels were measured when the subject was admitted to the hospital and there was clinical improvement.Results: There was a significant difference in reduced IL-6 levels (P=0.001), decreased MDA levels (P=0.001), and the duration of clinical improvement (P=0.042) between the treatment group and the control group. There was a moderate correlation between the decrease in IL-6 (R=0.480) and MDA (R=0.459), while the duration of clinical improvement had a strong correlation (R=0.756) in the treatment group.Conclusion: Supplementation of Omega-3 was effective in reducing IL-6, MDA levels, and the duration of clinical improvement in community-acquired pneumonia patients.

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