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Jurnal Respirologi Indonesia
ISSN : 08537704     EISSN : 26203162     DOI : -
Core Subject : Health,
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 364 Documents
Specific levels of calcidiol, calcitriol, cathelicidin and interferon gamma in diabetic patients with TB infection in Jakarta, Indonesia; Case control study Yunita Arliny; Dewi Behtri Yanifitri; Budi Yanti; Diennisa Mursalin
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.221

Abstract

Vitamin D plays a role in regulating the immune system via Vitamin D receptors, expressed by T-helper cells (Th). Cathelicidin LL-37 is an antimicrobial peptide that acts as the primary barrier against the Mycobacterium tuberculosis bacterial infection, which is induced by calcitriol, the active form of Vitamin D3. Interferon gamma (IFN-γ) is a cytokine released by Th-1 cells, and is essential for the elimination of M. tuberculosis. This study aims to determine the state of, and correlation between, calcidiol, calcitriol, cathelicidin and IFN-γ levels, as well as other clinical factors among patients with Type 2 Diabetes Mellitus (T2DM) with active TB coinfection. Further analysis is also performed to study the differences between T2DM patients with active tuberculosis, latent TB and without TB infection.
The Differences in Urokinase Plasminogen Activator System in Lung Cancer Patients Before and After Chemotherapy Tri Wahju Astuti; Agustin Iskandar; Mufidatun Hasanah; Lindayanti Sumali; Dian Nugrahenny
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.214

Abstract

Background: Lung cancer is still the leading cause of death for malignancies worldwide. Urokinase plasminogen activator (uPA), its soluble receptor (suPAR), and its inhibitor (PAI-1) play an important role in tumor invasion and metastasis. This study aimed to evaluate the differences in the urokinase plasminogen activator system (uPA, suPAR, and PAI-1) in lung cancer patients before and after chemotherapy.Methods: This research was an observational analytical study with a cross-sectional design. The subjects were 30, consisting of 17 lung cancer patients before chemotherapy and 13 lung cancer patients after chemotherapy for 4 or 6 cycles. The levels of serum uPA, suPAR, and PAI-1 were measured by enzyme-linked immunosorbent assay (ELISA). Results: In lung cancer patients before chemotherapy, there were no significant (p>0.05) differences in levels of serum uPA, suPAR, and PAI-1 between patients with stage III and IV. The highest serum uPA and suPAR levels were found in adenocarcinoma cell types and the highest serum PAI-1 level in adenoepidermoid cell types. After chemotherapy, serum suPAR and PAI-1 were significantly (p < 0.05) decreased in lung cancer patients. However, there were no significant (p>0.05) differences in the levels of serum uPA, suPAR, and PAI-1 between patients with chemotherapy responses for stable and progressive diseases. Conclusion: This study revealed that suPAR and PAI-1 levels were decreased in lung cancer patients who had received chemotherapy. This can occur due to decreased tumor cells activity. 
Analysis of Comorbidity and Its Association with Disease Severity and Mortality Rate in Hospitalized COVID-19 Patients Anthony Christanto; Aditya Sri Listyoko; Ngakan Putu Parsama Putra
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.278

Abstract

Background: Comorbidity is a major factor in determining the outcome of COVID-19. However, existing studies regarding comorbidities and the disease severity and mortality of COVID-19 are mostly based on studies in the whole community, and not on those admitted to hospitals. This study aims to determine the demographic profile of comorbidities among COVID-19 patients hospitalized in tertiary care referral hospitals and its association with disease severity and mortality. Methods: We analyzed the data from 60 laboratory-confirmed patients in our hospital in Malang City, East Java, Indonesia from March 12th, 2020 to June 5th, 2020. We describe the demographic profile of the patients and perform statistical analysis to determine its relationship to disease severity and mortality. Results: The majority of the study samples (66.7%) were categorized as having a severe disease. Thirty-seven samples (61.7%) had at least one comorbidity. The mortality rate among the study population is 30.0%, and 37.8% among those with comorbidities. The most prevalent comorbidity was hypertension (40.0%), followed by heart failure (35.0%) and diabetes (25.0%). There is a statistically significant relationship between the presence of comorbidities and disease severity and between disease severity and mortality (p<0.05). Diabetes was the only comorbidity with a significant relationship towards mortality in our study (p<0.05, OR 4.0 95% CI 1.16-13.74). Conclusion: Comorbidities are associated with worse disease severity and death in hospitalized COVID-19 patients. 
Inflammatory Markers upon Admission as Predictors of Outcome in COVID-19 Patients Budhi Antariksa; Erlina Burhan; Agus Dwi Susanto; Mohamad Fahmi Alatas; Feni Fitriani Taufik; Dewi Yennita Sari; Dicky Soehardiman; Andika Chandra Putra; Erlang Samoedro; Ibrahim Nur Insan Putra Darmawan; Hera Afidjati; Muhammad Alkaff; Rita Rogayah
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.185

Abstract

Background: Coronavirus disease 2019 (COVID-19) may cause dysregulation of the immune system, leading to hyperinflammation. Inflammatory markers can be used to predict in-hospital mortality in COVID-19 patients. This research was aimed to investigate the association between the levels of various inflammatory markers and mortality in COVID-19 patients.Methods: This study was conducted at Persahabatan National Respiratory Referral Hospital, Indonesia. Blood tests were performed upon admission, measuring the C-reactive protein, PCT, leukocyte, differential counts, and platelet count. The outcome measured was the mortality of hospitalized COVID-19 patients. Statistical analysis methods included the Mann–Whitney U test, receiver operating characteristic (ROC) analysis, and area under the curve (AUC) test.Results: Total 110 patients were included, and the laboratory values were analyzed to compare survivors and non-survivors. The non-survivor group had significantly higher leukocyte count, lower lymphocyte count, higher CRP and PCT levels, higher neutrophil-to-lymphocyte ratio (NLR), higher platelet-to-lymphocyte ratio (PLR), and lower lymphocyte-to-CRP ratio. As predictors of mortality, AUC analysis revealed that PCT, CRP, NLR, and PLR had AUCs of 0.867, 0.82, 0.791, and 0.746, respectively.Conclusions: Routine and affordable inflammatory markers tested on admission may be useful as predictors of in-hospital mortality in COVID-19 patients requiring hospitalization.
Increased Serum SP-D Level, Neutrophils and Lymphocytes Sputum in Malang Splendid Bird Market Workers Ratih Dwi Ary Merdekawati; Tri Wahju Astuti; Garinda Alma Duta
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.304

Abstract

Background: Workers in the bird market have a high risk of exposure in the form of air pollution, pollutant particles including debris / organic dust, loose feathers, insects/ticks, aerosol particles in food, bird excreta (ammonia), various kinds of gram bacteria, fungi and virus. Exposure to particles will stimulate the immune system against harmful pathogens in the form of inflammatory response. An infection or injury will stimulate the secretion of Surfactant protein-D (SP-D) which is a group of collectin (collagen-lectin) with subgroups of the C-type lectin superfamily, together with bovine coglutinin, mannose-binding lectin (MBL), and CL43 protein. This aim of this study was to determine serum SP-D and neutrophil and sputum lymphocyte levels in workers at splendid bird market.Methods: A cross sectional analytic observational study on 35 subjects, analyzed the characteristics of the workers, calculated neutrophil types, lymphocytes on induced sputum and serum SP-D levels using sandwich ELISA.Results: Mean SP-D serum levels in workers in the bird market environment increased (mean SD: 81.39 + 47.656 ng/ml) from normal levels (60 ± 3 ng/ml). There was a significant positive correlation between length of exposure and serum SP-D levels (r: 0.693; p <0.001). There was an average increase in the percentage of neutrophils and sputum lymphocytes (90.71% + 4.04% and 9.17% + 4.42%) compared to normal limit (50.3% + 23.5% and 2.6% + 5.2%).Conclusion: Inhalation exposure in the Bird Market environment can cause an increase in the percentage of neutrophils, sputum lymphocytes and serum SP-D levels in workers that indicate an airway inflammation process, as well as an alleged increase in alveolar wall permeability, damage and regeneration of alveolar epithelial cell type II cells (AEC type II).
The Correlations Between Measurement of Lung Diffusing Capacity for Carbon Monoxide and The Severity Group of Asthma Patients in Persahabatan Hospital Jakarta Bulkis Natsir; Faisal Yunus; Triya Damayanti
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.296

Abstract

Introduction: Airway remodeling in asthma which involve small airway can affect until alveoli and cause abnormalities in the lung parenchyma. This study tries to find lung parenchymal abnormalities in patients with asthma through the examination diffusion capacity with a single breath DLCO method.Methods: A cross-sectional study by dividing asthma based on the degree of severity into two major groups, namely mild asthma (intermittent and mild persistent) and severe (persistent moderate and severe). The amount of each group is 31 subjects and 29 subjects, which are taken consecutively from stable asthma patients without comorbid who are seeking treatment in Persahabatan Hospital in December 2015 - May 2016.Results: The average value of DLCO /predictions in mild asthma group is 92,74 ± 15,70% and decreased in the severe asthma group is 77,45 ± 16,78%. Some spirometry value showed significant positive correlation with the value of DLCO/prediction, namely: FVC/prediction, FEV1 /prediction and FEF25-75 % / prediction with p < 0.05. Correlation analysis showed FVC/prediction could dramatically affect the diffusion capacity of asthmatic patients. There is a significant relationship between abnormalities in lung function (p=0,004) and severity of asthma (p=0.000) with a corresponding decrease DLCO / prediction (DLCO/ prediction ≤75 %).Conclusion: The severity of asthma has a relationship with the diffusion capacity of the lungs, increased severity will decrease the diffusion capacity in asthma patients. Decreasing diffusion capacity showed that abnormalities in asthma not only occur in the respiratory tract but also in the lung parenchyma.
Impact of Underweight on the Unsuccessful Treatment Outcome among Adults with Drug-Resistant Tuberculosis: A Systematic Review Kemas Rakhmat Notariza; Jaka Pradipta
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v41i4.228

Abstract

Background: The emergence of drug-resistant (DR) strains of Mycobacterium tuberculosis has disrupted the control of tuberculosis (TB) problem worldwide. Most of DR-TB patients presents with underweight problems. Prior studies showed that body mass index affects sputum conversion and could be a predictor of treatment outcome, but the causal relationship has not been established yet. This systematic review aimed to determine the impact of underweight on the unsuccessful treatment outcome among adults with DR-TB.Methods: Systematic literature search and handsearching were done in four databases: Cochrane, Proquest, Pubmed, and ScienceDirect. Filtering process by using selection criteria yielded 4 eligible articles (2 prospective cohort and 2 retrospective cohort studies) for answering the clinical question. Critical appraisal was conducted by using the Newcastle-Ottawa Quality Assessment Scale (NOS).Results: All four studies were assessed as having high quality according to the NOS score. The findings of all eligible studies were consistent in revealing the impact of underweight on the unsuccessful treatment outcome in DR-TB, with the relative risk: 2.194 (95% confidence interval [CI], 1.134–4.246), 1.771 (95% CI, 1.069–2.931), 3.465 (95% CI, 1.114–2.712), and 4.703 (95% CI, 1.709–12.947), consecutively. The number needed to harm (NNH) of 3–7 indicated the clinically meaningful harm of the exposure. This systematic review showed that one poor outcome incidence could be found with only a few underweight DR-TB patients.Conclusion: Underweight increased the risk of unsuccessful treatment outcome among adults with DR-TB. Low baseline body weight (<40 kg) could be another considerable factor in anticipating the poor treatment outcome. 
Differences in Levels of Human 1,3β-D-Glucan from Bronchoalveolar Lavage (BAL) Fluid in The Immunocompromised and Immunocompetent Groups Patients with Suspected Lung Cancer Asih Trimurtini; Ngakan Putu Parsama Putra; Teguh Rahayu Sartono; Harun Al Rasyid
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.298

Abstract

Background: Invasive candidiasis occurs in immunocompromised individuals as an opportunistic infection in patients with lung cancer. Although culture and histopathology remain the standard diagnosis of fungal infections, other tests are still needed to provide faster results. Human 1,3-β-D-Glucan (BDG) uses ELISA to detect candidiasis. β D-Glucan level from BAL fluid is positive when the cut-off is p 130 pg / mL. This study aims to determine differences in the levels of Human 1,3β-D-Glucan from Bronchoalveolar Lavage (BAL) fluid between the immunocompromised and immunocompetent groups in patients with suspected lung cancer at RSU Dr. Saiful Anwar Malang.Method: A cross-sectional study was conducted on 33 lung cancer patients who had risk factors for invasive candidiasis in Dr. Saiful Anwar Hospital Malang.Result: 33 study patients had significant differences in BAL levels of Human 1,3β-D-Glucan in the immunocompromised and immunocompetent groups (p = 0.009). In the different tests, there was a slight difference in the levels of BAL Human 1,3β-D-Glucan but it was not statistically significant based on age and sex in the immunocompromised and immunocompetent groups (p = 0.632, p = 0.338, p = 0.472, p = 0.667).Conclusion: Patients suspected of lung cancer have risk factors for invasive candidiasis with higher BDG levels due to immunoparalysis. There were significant differences in the BAL Human levels of 1,3β-D-Glucan in the immunocompromised and immunocompetent groups.
Immune Checkpoint Marker of Programmed Death Ligand-1 (PD-L1) Expression in Surgical Lung Cancer Specimens Elisna Syahruddin; Jamal Zaini; Lisnawati Lisnawati; Yayi DB Susanto; Sarah Fitriani; Shanty R. Kusumawardani; Romi Baginta
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.286

Abstract

Background: Currently immune checkpoint pathways of PD1-PD-L1 is being used to treat lung cancer and PD-L1 served as predictive biomarker. Investigations of PD-L1 expression as a target immunotherapy in lung cancer specimens in Indonesia is needed. This study aimed to evaluate PD-L1 expression in resected lung cancer specimens using immunohistochemistry techniques. Methods: Thirty surgically resected sample from lung cancer patients were obtained. The whole specimens were stained by using immunohistochemistry techniques automatically in BOND-MAX Autostainner (Leica, Germany). PD-L1 polyclonal antibody (Genetex) at 1:1500 dilution was applied to immunohistochemistry staining procedure. Clinicopathological characteristic were acquired from the hospital registry database.Result: A total of 30 surgical specimens were assessed from lung cancer patients. Twenty-four (80%) of them were Adenocarcinoma (AC), 1 (3, 33%) Adenosquamous carcinoma, 2 (6, 67%) were Squamous Cell Carcinoma (SSC), 1 (3, 33%) were Large Cell Carcinoma, 1 (3, 33%) were Neuroendocrine Carcinoma, 1 (3, 33%) were Adenoid Cyctic Carcinoma. The expression of PDL-1 positive reactivity was 16 of 30 (53.3%) specimens and we categorized into strong positivity (>50%), medium (= 50%) and low positivity (<50) from 21 specimens, 0 specimens and 7 specimens respectively.Conclusion: PD-L1 expression could be detected in lung cancer specimen using polyclonal antibody.
Risk Factors for Mortality of Patients with Covid-19 in RSJPD Harapan Kita, Jakarta Zhara Juliane; Asri Chasanah Adisasmita; Yoga Yunadi
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.287

Abstract

Abstract Background:TheCovid-19 disease has caused significant morbidity and mortality worldwide since Covid-19 was first reported in December 2019. More intense kinds of the disorder main to loss of life arise greater regularly in older sufferers and people with more than one comorbidities. This study  aims  to determine the risk factors associated with death in Covid-19 patients at RSJPD Harapan Kita.Methods:A total of 500 patients with a positive result on the Covid-19 polymerase-chain-reaction (PCR) test from RSJPD Harapan Kita were analyzed. The Demographic, clinical, and outcome data were extracted from the hospital's medical record system.  To explore the risk factors associated with mortality, univariable and multivariable logistic regression analyses were used.Results:Of the 500 patients included in this study, 110 (22%) died in the hospital. The multivariate regression analysis showed that age³65 years (adjusted odds ratio (aOR), 2,624; (95% CI: 1,552 – 4,435), chronic lung disease (aOR, 8,173; 95% CI: 3,834 – 17,422), chronic kidney disease (aOR,2,523; 95% CI: 1,358 – 4,689), and cardiovascular disease (aOR, 3,149; 95% CI: 1,763 – 5,624) had been recognized as risk factors of mortality among Covid-19 patients. Conclusion: Age ³65 years, chronic lung disease, chronic kidney disease patients, and cardiovascular disease had been recognized as risk factors of mortality among Covid-19 patients in RSJPD Harapan Kita. More research on the risk factors related to Covid-19-associate death is had to manage ailment development and to enhance its treatment.Keywords: Covid-19, Risk Factors, Mortality, Comorbidities.