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Jurnal Respirasi (JR)
Published by Universitas Airlangga
ISSN : 24070831     EISSN : 26218372     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Jurnal Respirasi is a National journal in accreditation process managed by Department of Pulmonology & Respiratory Medicine Faculty of Medicine Airlangga University - Dr. Soetomo General Hospital, Surabaya. Publish every January, May, September every year with each of 5 (five) complete texts in Indonesian.
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Articles 13 Documents
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Search results for , issue "Vol. 12 No. 1 (2026): January 2026" : 13 Documents clear
Change in Adenosine Deaminase Serum Levels from Before and Six Months After Treatment in Patients with Tuberculous Lymphadenopathy Muljono, Christa Graziella; Soedarsono, Soedarsono
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.1-5

Abstract

Introduction: Tuberculous lymphadenopathy (TBLN) is challenging to both diagnose and treat. The outcome of a complete course of anti-tuberculosis (TB) drugs (ATDs) is evaluated based on clinical presentation and symptom improvement. Many clinicians administer ATDs for more than 6 months when they find residual lymphadenopathy or a paradoxical reaction. Therefore, this study assessed whether serum adenosine deaminase (ADA) levels are a suitable marker for evaluating the response to TBLN treatment and for analyzing changes in serum ADA levels from before to after 6 months of treatment with the standard ATD regimen in patients with TBLN. Methods: This prospective analytic observational study enrolled ATD-naïve patients with TBLN who received the standard 6-month ATD regimen in the TB directly observed therapy outpatient wards at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital, Surabaya, from May 2023 to June 2024. Serum ADA levels were determined before and after treatment and compared using the Wilcoxon signed-rank test. Results: This study enrolled 22 patients, mostly female (n=14, 63.6%), with a mean age of 29.55±8.92 years old. The median serum ADA level was 18.7 (12.5-42.5) IU/L before and 13.9 (9.6-27.1) IU/L after treatment, with a significant mean decrease of -4.55 IU/L (p=0.001). Conclusion: Treatment with the standard 6-month ATD regimen decreased serum ADA levels in patients with TBLD. Therefore, serum ADA levels can be used as a follow-up test after treatment for patients with TBLN to evaluate their response to anti-TB therapy.
Assessment of Heavy Risk Factor Association with Lung Cancer Risk Using Questionnaire-Based Screening: A Cross-Sectional Study at Medan Johor Public Health Center, Medan, Indonesia Auliya, Muhammad Azka; Soeroso, Noni Novisari; Amelia, Rina; Dalimunthe, Dina Arwina; Lim, Darren Wan-Teck
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.6-12

Abstract

Introduction: Lung cancer remains a major public health concern in Indonesia, characterized by high morbidity and mortality rates. Effective prevention and management strategies necessitate the accurate identification of lung cancer risk factors. The questionnaire was developed and validated as a screening tool to evaluate risk factors and generate lung cancer risk scores. This study aimed to assess the questionnaire’s utility for identifying lung cancer risk factors and categorizing risk levels among individuals at the Medan Johor Public Health Center, Medan, Indonesia. Methods: This study enrolled 180 subjects who met the inclusion criteria. These subjects were part of the population, specifically non-lung-cancer patients at the Medan Johor Public Health Center in Medan, Indonesia. A cross-sectional analytic design was used to examine the correlation between risk factors and risk levels. Results: Among 180 lung cancer patients screened, the tool classified most individuals into moderate- to high-risk strata and showed significant between-group differences for most risk factors (p<0.05). In addition, the Kenali Paru (NARU) screening tool is accessible, reproducible, and cost-effective, using a 14-item multiple-choice format (2-3 options per item) with weighted scoring that converts responses into a total risk score. Conclusion: The questionnaire demonstrates its effectiveness as a screening tool for identifying lung cancer risk factors and stratifying risk levels. Nevertheless, refinement is necessary to address its limitations, including the addition of tailored questions for sub-populations with specific comorbidities or health conditions.
Early Rehabilitation for the Prevention and Management of Pleural Empyema: A Narrative Review Nazir, Arnengsih; Prananta, Marietta Shanti; Rachmi, Ami; Ferjuniko, Vecky
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.72-81

Abstract

Introduction: Parapneumonic effusions (PPE) can progress to pleural empyema (PE), a severe condition associated with increased morbidity and mortality. Pleural empyema impairs lung function due to pleural inflammation, fluid accumulation, and restricted diaphragm movement. Patients with severe PPE and PE often require intensive care, where prolonged immobilization and mechanical ventilation further exacerbate respiratory decline. Early rehabilitation (ER) has shown promise in reducing complications associated with prolonged intensive care unit (ICU) stays, but its role in preventing PE remains unclear. This review aimed to assess the impact of ER on PE prevention and on clinical outcomes. Methods: A literature search was conducted using PubMed and Google Scholar, focusing on original research and case reports related to PE, ICU care, and ER interventions. Only full-text English articles were included. Results: Ten studies met the inclusion criteria, comprising four original research articles and six case reports. Early rehabilitation, including respiratory physiotherapy, early mobilization, and targeted exercises, has been shown to enhance lung expansion, prevent atelectasis, and reduce postoperative pulmonary complications. It also improved oxygenation, secretion clearance, functional capacity, and psychological well-being. Patients receiving structured ER programs had shorter hospitalizations and better overall outcomes. Conclusion: Early rehabilitation plays a crucial role in mitigating respiratory complications in critically ill patients by reducing the incidence of PE, improving pulmonary mechanics, and preventing pleural adhesions. While further large-scale studies are needed, current evidence supports integrating ER into ICU protocols to optimize respiratory function, enhance recovery, and improve quality of life in patients at risk of PE.
Emerging Bedaquiline Resistance in Pulmonary Tuberculosis Patients of a Tertiary Hospital in Jakarta, Indonesia Isbaniah, Fathiyah; Haryanto, Budi; Lubis, Nabila Assakinah; Maharani, Cindy Refina; Agustin, Heidy; Hatim, Faiza; Sutarto, Riyadi; Handayani, Raden Rara Diah; Islam, Muhammad Nashirul; Heldian, Muhammad Hibban; Faizal, Fathia Amalia; Herawati, Aulia Rizkia
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.20-26

Abstract

Introduction: Tuberculosis (TB) continues to pose significant health and economic challenges globally. Drug-resistant TB (DR-TB), particularly resistance to bedaquiline (BDQ), threatens the efficacy of current treatment regimens. Limited phenotypic drug susceptibility testing (DST) capacity exacerbates the issue, delaying appropriate interventions. This study examined BDQ resistance patterns among pulmonary DR-TB patients in Indonesia, where evidence on BDQ resistance remains scarce. Methods: A retrospective analysis of 393 DR-TB cases was conducted using data from the National TB Database (SITB) at Persahabatan National Respiratory Referral Hospital, Jakarta, Indonesia, between 2021 and 2023. Patients were classified based on the World Health Organization (WHO) 2022 DR-TB guidelines. Resistance patterns were determined through phenotypic DST using the BACTEC Mycobacteria Growth Indicator Tube (MGIT) system. Descriptive statistics summarized patient demographics and resistance profiles. Results: Among the 393 patients, 10 (2.54%) demonstrated BDQ resistance, with 8 cases arising without prior BDQ exposure. Mono/poly-resistance to Rifampicin and/or Isoniazid was the most prevalent pattern (44.29%). Multidrug-resistant TB (MDR-TB) was observed in 40.20% of cases, while pre-extensively DR and extensively DR-TB constituted 7.90% and 0.25%, respectively. Comorbidities, predominantly diabetes mellitus (DM), were identified in 33.59% of patients. Conclusion: This study revealed an alarming BDQ resistance rate (2.50% in MDR-TB cases), underscoring the urgent need for improved access to DST and TB management infrastructure in Indonesia. Strengthening diagnostic capacity and monitoring systems is critical to mitigating the spread of resistance and supporting effective treatment strategies.
Massive Pleural Effusion Leads to the Revelation of Malignant Pleural Mesothelioma: A Case Report Wijaya, Gede Adi Prasetya; Oei, Ivan Leonard Winardy; Putra, Wayan Wahyu Semara; Novitasari, Novitasari
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.52-56

Abstract

Introduction: Malignant mesothelioma is a cancer that develops from the thin layer of tissue covering visceral organs (mesothelium). Up to 80% of malignant mesothelioma cases are caused by asbestos exposure. This case report describes a 56-year-old female with massive left pleural effusion caused by malignant mesothelioma. Case: A 56-year-old female presented with complaints of shortness of breath for two months, accompanied by right chest pain. Her prior hospital history showed massive left pleural effusion and a prominent lesion in the parietal pleura, suspected as mesothelioma. She had undergone an indwelling pleural catheter insertion and a bronchoscopy examination. However, her complaints persisted. Physical examination revealed thoracic asymmetry and retraction of the left chest wall. Supporting imaging studies revealed a massive left pleural effusion with multiple prominent lesions in the parietal pleura. Conclusion: Asbestos exposure is a major cause of malignant mesothelioma. In this case, the patient had a history of asbestos exposure while working as a laborer in a building materials store, which led to the development of malignant mesothelioma, which caused a massive left pleural effusion. Since malignant mesothelioma is a rare and incurable disease with a generally poor prognosis, the patient’s management primarily involved supportive and palliative therapy to reduce symptoms.
Digital Technology in Improving Tuberculosis Treatment Adherence: A Systematic Review Jasmine, Amirah; Husna, Annisa Nurul; Kamal, Safira
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.82-90

Abstract

Introduction: Indonesia ranks second globally in the number of tuberculosis (TB) cases. One strategy to eliminate TB is to use research and technology. The long duration of treatment may lead to non-adherence. Digital health interventions have become a promising option for monitoring treatment adherence. This review aimed to evaluate how digital technology interventions can improve treatment adherence in TB. Methods: A systematic review was conducted by identifying primary data articles published on online platforms by using specific keywords. The sample size was determined in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All data were then systematically assessed and reviewed. Results: Of the 14 included studies, 13 found that digital technology led to high adherence to TB medication, while 1 found no link between usability and medication adherence. The intervention arm reached 99 % (pill dispenser) in adherence, and the lowest was 71.1 % (video-observed therapy). Conclusion: Digital technology intervention still has some obstacles despite promising outcomes. The limitations are poor internet connectivity, mobile phone ownership, and inferior-quality phones. This review could not assess the degree of adherence alteration, as the included studies showed adherence only at the end of the study. In addition, 4 of the 14 studies were categorized as having some concerns based on the risk of bias tool. Further studies are needed to assess how digital technology influences adherence to TB medication.
Adjunctive Effects of Bajakah Wood (Spatholobus littoralis Hassk.) on Cholesterol and Triglyceride in EGFR Wild Type Lung Adenocarcinoma Patients Nikmah, Elok Hikmatun; Kusumawardhani, Erna; Suhartono, Eko; Nurrasyidah, Ira; Ansori, Isa; Assagaf, Ali; Isa, Mohamad; Haryati, Haryati; Oktaviyanti, Ika Kustiyah
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.13-19

Abstract

Introduction: Lung cancer is the leading cause of cancer mortality, influenced by uncontrolled cell proliferation, migration, metastasis, and mutations. The imbalance of high-density lipoprotein (HDL) and triglycerides (TG) has an important role. Spatholobus littoralis Hassk., or Bajakah wood, has antioxidant effects due to dihydrokaempferol, which lowers cholesterol levels and increases HDL. This additional therapy is expected to have a positive impact, supporting treatment for patients with wild-type lung adenocarcinoma. Methods: This was a single-blind clinical trial conducted at Ulin General Hospital, Banjarmasin, Indonesia, in patients with epidermal growth factor receptor (EGFR)-wild-type lung adenocarcinoma at a minimum stage IIIA, from June 2023 to July 2024. The participants were divided into two groups: the treatment group (adjunctive Bajakah wood 1,000 mg) and the control group. Cholesterol, low-density lipoprotein (LDL), HDL, and TG were measured twice before starting chemotherapy and after the third chemotherapy cycle. The resulting data were analyzed using the independent t-test and the Mann-Whitney test through the Statistical Package for the Social Sciences (SPSS) version 26. Results: For the 21 total patients, the cholesterol and TG levels in the treatment group before and after the third chemotherapy were 200.55±42.65 to 184.45±24.20 and 131.27±44.76 to 112.73±34.74, respectively. The control group results were 185.10±51.98 to 168.30±32.89 and 118.30±51.30 to 104.10±12.53, respectively. The comparison of changes between the two groups was not significant (p-value > 0.005). Conclusion: Cholesterol and TG levels were reduced, but there were no statistically significant differences after the addition of therapy with Bajakah wood.
Potential Biomarkers and Inflammatory Modulation of Hyperbaric Oxygen Therapy in Long COVID: A Narrative Update Soedarsono, Soedarsono; Wijaya, Rike Andy; Biutifasari, Verna
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.91-97

Abstract

Introduction: Long coronavirus disease (COVID-19), also known as post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC), is characterized by persistent, often debilitating symptoms that extend beyond the acute phase of COVID-19. These manifestations are associated with immune dysregulation, chronic inflammation, and oxidative stress. Hyperbaric oxygen therapy (HBOT), which involves inhaling 100% oxygen at elevated atmospheric pressure, has emerged as a potential intervention to mitigate these processes. This narrative review synthesized findings from recent clinical and translational studies evaluating the immunological effects of HBOT in patients with long COVID. Methods: A structured search of PubMed, Scopus, and ScienceDirect was conducted for articles published between January 2020 and April 2025 using predefined keywords related to HBOT, long COVID, inflammation, and biomarkers. Seven primary studies met the inclusion criteria and were analyzed for their clinical outcomes and molecular immunomodulatory effects. Results: Evidence indicates that HBOT contributes to significant reductions in pro-inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor-α (TNF-α), while increasing anti-inflammatory cytokines like IL-10. Improvements in systemic biomarkers, including C-reactive protein, ferritin, and reactive oxygen species (ROS), have also been observed. In parallel, HBOT has been linked to enhanced mitochondrial function, immune balance, and tissue oxygenation, all of which support recovery from long COVID-related organ dysfunction. Conclusion: Despite promising results, heterogeneity in study design, small sample sizes, and limited long-term follow-up highlighted the need for further rigorous, standardized clinical trials. Overall, HBOT appears to be a biologically plausible and clinically relevant adjunctive therapy in long COVID, with inflammation-related biomarkers acting as correlates or secondary indicators that may reflect therapeutic response.
Endobronchial Tuberculosis Masquerading as a Lung Mass: A Rare and Challenging Diagnosis Wedadinanta, I Gusti Ngurah Purwa; Widyaningsih, Putu Dyah; Yandi, I Komang Rusgi
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.57-63

Abstract

Introduction: Endobronchial tuberculosis (EBTB) is a rare form of tracheobronchial infection by Mycobacterium tuberculosis (MTB). It is estimated to occur in 10-40% of patients with active pulmonary TB. It often presents atypically and mimics other diseases, particularly in asymptomatic individuals. Case: We report a 25-year-old immunocompetent male with no respiratory symptoms or TB risk factors, who was incidentally found to have a pulmonary mass during routine chest X-ray screening. Physical and laboratory examinations were unremarkable. Chest computed tomography (CT) scan with contrast revealed an intensely contrast-enhancing solid mass in the posterior segment of the left lower lobe. Bronchoscopy showed partial obstruction of the left lower lobe bronchus with hyperemic, friable mucosa. Histopathology confirmed caseating granulomatous inflammation, establishing the diagnosis of EBTB. The patient was classified as having single-level EBTB and was treated with standard anti-TB therapy, without corticosteroids. Conclusion: This case highlights the diagnostic challenge of EBTB in individuals without typical symptoms or exposure history. Endobronchial TB presents a diagnostic challenge due to its variable and non-distinct clinical manifestations. Environmental exposure in TB-endemic regions, such as Indonesia, may play a role. The absence of molecular testing (e.g., tissue GeneXpert) is a limitation, though early histological diagnosis enabled timely management. Endobronchial TB should be considered in asymptomatic pulmonary lesions, particularly in endemic regions. Bronchoscopy and biopsy remain key to early detection of the disease.
Persistent Pneumothorax in Neurofibromatosis Type-1 Simamora, Hustorio Aliongko; Djajalaksana, Susanthy; Chozin, Iin Noor; Erawati, Dini Rachma; Yudhanto, Hendy Setyo; Damanik, Gracelia Ruth Elisabeth; Dani, Adinda Amalia; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.64-71

Abstract

Introduction: Neurofibromatosis type 1 (NF-1) is a rare autosomal dominant disorder. While typically recognized by its cutaneous features, pulmonary involvement, including apical cysts and basal interstitial fibrosis consistent with interstitial lung disease (ILD), can occur in up to 20% of patients. These manifestations create a predisposition to complications such as spontaneous pneumothorax. While this is relatively uncommon, occurring in approximately 1.5% of patients with NF-1, it represents a serious and potentially life-threatening complication when it does occur. Case: A 52-year-old male with a 20-pack-year smoking history and active pulmonary tuberculosis (TB) presented with acute chest pain and dyspnea. Dermatological examination and skin biopsy confirmed the diagnosis of NF-1. A high-resolution computed tomography (HRCT) scan of the chest revealed multiple subpleural pulmonary cysts consistent with NF-1-related ILD, alongside findings suggestive of active TB. The patient was diagnosed with a secondary spontaneous pneumothorax, which proved to be persistent despite initial chest tube drainage, ultimately requiring surgical intervention. Conclusion: This case highlights that NF-1 is a significant underlying risk factor for persistent pneumothorax, particularly when co-existing with other conditions like active TB and a history of smoking. The chronic inflammation and parenchymal destruction associated with these comorbidities can exacerbate the inherent structural lung abnormalities in NF-1, leading to complex, difficult-to-manage clinical scenarios. Early recognition of pulmonary manifestations in patients with NF-1 is crucial for anticipating and managing severe complications.

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