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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. 3 (2026): september 2026" : 13 Documents clear
Non-Tuberculous Mycobacteria: Emerging Pathogens in Pulmonary and Extrapulmonary Infections - A Comprehensive Review Irene Oinike; Rohani Lasmaria; Zarfiardy Aksa Fauzi; Indra Yovi; Nadya Arawinda Andar
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.301-309

Abstract

Non-Tuberculous Mycobacteria (NTM) refers to a group of Mycobacterium other than Mycobacterium tuberculosis complex and Mycobacterium leprae, which are commonly found in air, soil and water. Although most NTM species are non-pathogenic, certain species can cause pulmonary and extrapulmonary infection, particularly in immunocompromised. Diagnosing pulmonary infections caused by non-tuberculous mycobacteria requires an integrated assessment of clinical manifestations, physical examination, radiology and microbiology or histopathology examination. In extrapulmonary infection, diagnosis involves a combination of clinical symptoms, physical examination, microbiology and histopathology examination. Molecular examination may also be employed as an adjunct to confirm the presence of NTM infection. NTM infection may become progressive, therefore require appropriate treatment to reduce morbidity and mortality. Treatment consists of both pharmacological approaches using combination antibiotic regimens and non-pharmacological such as supportive therapy, surgery and physiotherapy. This literature review aims to provide a comprehensive overview of definition, classification, pathogenesis, diagnosis, management and prognosis of NTM infection.
Pulmonary Langerhans Cell Histiocytosis: Insights into Pathogenesis, Diagnostic Challenges, and Management Strategies Peter Krisdiyanto; Iin Noor Chozin; Sastia Rakhma
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.282-291

Abstract

Introduction: Pulmonary Langerhans Cell Histiocytosis (PLCH) is a rare interstitial lung disease strongly linked to cigarette smoking, characterized by nodular and cystic lesions predominantly in the upper and middle lung zones. The disease course is heterogeneous, ranging from spontaneous remission to progressive respiratory failure, with diagnostic and therapeutic challenges requiring a multidisciplinary approach. Methods: This narrative review synthesized evidence from peer-reviewed journals and updated guidelines published in the last decade, emphasizing studies within the past five years. Relevant articles were identified through electronic databases focusing on epidemiology, pathogenesis, diagnostic modalities, and management strategies of PLCH. Results: Cigarette smoke is the main environmental trigger, sustaining Langerhans cell proliferation and chronic inflammation. Molecular studies demonstrate recurrent somatic mutations, particularly BRAF V600E and MAP2K1, confirming PLCH as an inflammatory myeloid neoplasm and supporting targeted therapy. High-resolution computed tomography (HRCT) remains the imaging cornerstone, showing nodular and cystic changes, while histopathology with immunohistochemistry (CD1a, langerin, S100) is the diagnostic gold standard. Pulmonary function testing, bronchoalveolar lavage, and molecular assays add diagnostic precision. Management emphasizes smoking cessation as the primary intervention, with variable outcomes from glucocorticoids and chemotherapy. Targeted therapy with BRAF and MEK inhibitors shows promise in mutation-positive patients, though long-term safety is still under study. For advanced disease, pulmonary hypertension management and lung transplantation are considered. Conclusion: PLCH illustrates the interaction between environmental exposure and molecular oncogenesis. Early diagnosis via HRCT and molecular confirmation is essential, smoking cessation remains central, and ongoing research into biomarkers and targeted interventions may improve personalized outcomes.
Nanoparticles in Cancer Therapy: Recent Advances and Clinical Implications in Pulmonary Oncology Albert Lyono; Ungky Agus Setyawan; Sastia Rakhma
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.292-300

Abstract

Introduction: Lung cancer remains the leading cause of cancer-related mortality worldwide and in Indonesia, with most patients presenting at advanced stages and experiencing limited survival. Conventional therapies such as surgery, chemotherapy, and radiotherapy face major limitations, including systemic toxicity, poor specificity, and treatment resistance. Nanotechnology has emerged as a transformative approach in oncology, offering novel solutions for diagnosis and therapy through nanoparticles with unique physicochemical properties. Methods: This narrative literature review synthesized evidence from the past five years using PubMed, Scopus, and Google Scholar. Articles were selected for relevance to nanoparticle applications in lung cancer. Data extraction emphasized diagnostic advances, therapeutic strategies including chemotherapy, radiotherapy, and immunotherapy, as well as emerging modalities and translational challenges. Results: Nanoparticles show strong potential to improve diagnostic accuracy and therapeutic efficacy. As imaging contrast agents in CT, MRI, and PET, nanoparticles such as gold and superparamagnetic iron oxide enhance sensitivity and specificity. In chemotherapy, delivery systems including liposomes, polymer, and lipid nanoparticles increase bioavailability while reducing toxicity. Metallic nanoparticles serve as radiosensitizers in radiotherapy, mitigating resistance and sparing normal tissues. Nanoparticles also act as carriers for checkpoint inhibitors, cytokines, and vaccines to enhance immune activation. Emerging modalities include photothermal therapy, cryosurgery, and gene or mRNA delivery. Despite these advances, challenges persist regarding toxicity, long-term biodistribution, scalability, regulatory approval, and cost-effectiveness, particularly in low–middle income countries. Conclusion: Nanoparticles represent a promising paradigm shift in pulmonary oncology, offering precision, reduced toxicity, and integration with personalized and precision medicine to improve lung cancer outcomes.
Lead Levels and Pulmonary Function Disorders in Mall Parking Attendants in Pekanbaru, Indonesia Anggie Yumanda; Indi Esha; Zahtamal Zahtamal; Faisal Yunus; Elvando Tunggul Mauliate Simatupang
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.193-201

Abstract

Background: Air pollution, particularly from motor vehicles, has a significant impact on respiratory health, especially among high-risk groups, such as parking attendants who are directly exposed. Lead (Pb) is a toxic air pollutant that can impair lung function by binding with red blood cells. Elevated Pb levels pose a risk of respiratory dysfunction and various other health problems. Methods: This study used a cross-sectional design to analyze the relationship between blood Pb levels and lung function impairment among mall parking attendants in Pekanbaru. Data were collected using sociodemographic questionnaires, blood Pb level measurements, and spirometry tests. Other factors considered included age, gender, work duration, smoking habits, and nutritional status. Results: The study found that 50.60% of parking attendants in Pekanbaru have blood lead (Pb) levels exceeding normal limits. A significant relationship exists between Pb levels and lung function impairment (χ² = 14.646; p < 0.001; PR = 3.34). Work duration of ≥ 5 years is significantly associated with lung impairment (PR = 2.64; p = 0.002), as is smoking habit (PR = 3.15; p = 0.001). Logistic regression identifies Pb levels as a key predictor of lung function impairment (p = 0.002; OR = 5.485), with an AUC of 0.763. Conclusion: Lead exposure from vehicle emissions is associated with an increased risk of lung function impairment among mall parking attendants. Interventions to reduce exposure to air pollution, particularly from lead, are crucial to prevent further health problems in this group
Case Series: Uncommon and Compound Mutations Exon 19 Deletion/20 Insertion and Exon 21 L858R/V834L in Lung Adenocarcinoma Hendro Suryadi; Ungky Agus Setyawan; Yani Jane Sugiri; Dini Rachma Erawati; Hendy Setyo Yudhanto; Sastia Rakhma
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.258-266

Abstract

Introduction: Mutation in lung adenocarcinoma pose significant challenges in lung malignancy management. Next‑generation sequencing can reveal uncommon variants and drug‑resistance mechanisms that require personalized therapy. Case: First case, 68 years old female diagnosed with lung nodules since 2021 without regular check-ups. In September 2023, the patient diagnosed with Left Lung Adenocarcinoma T4N2M1b stage IVA with EGFR exon 20 insertion but she refused chemotherapy and got afatinib for seven months until the symptoms re-occurred. EGFR with NGS in March 2024 showed additional exon 19 deletion and afatinib continued till the patient showing grade III cutaneous–gastrointestinal adverse effects and followed by dosage adjustment Patient's condition worsened in June 2024. Second case, 61 years old female diagnosed with right lung adenocarcinoma T4N2M1c Stage IVB with exon 21 L858R in January 2022. Patient underwent afatinib therapy showing good results. After 24 months, subsequently became symptomatic, and EGFR testing detected additional T790M EGFR gene leading treatment change to osimertinib with unsatisfactory results. NGS-liquid biopsy in May 2024 showed compound mutation exon 21 L858R - exon 21 V834L with resistance to osimertinib. Patient’s condition worsened in August 2024. Conclusion: Lung adenocarcinoma can mutate to not only uncommon but also rare mutations, such as exon 20 insertion and V834L, leading to TKI resistance despite the patient's clinical improvement. This represents a significant therapeutic challenge in the management of adenocarcinoma and requires a comprehensive, personalized treatment approach. Keywords: Adenocarcinoma, Uncommon mutation, Drug Resistance
Thoracic Ultrasound as a Diagnostic Bridge in Tuberculosis-Mimicking Advanced Lung Cancer: A Case Report from a Peripheral Hospital Frans Raffael Anggi Butar Butar; Charles Butar Butar; Hotma Hutabarat; Berlin Hutahean
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.267-273

Abstract

Introduction: The delay in lung cancer diagnosis remains a significant issue in peripheral hospitals due to limited facilities such as CT scans, bronchoscopy, and cytological and histopathological examinations. This condition often leads to misdiagnosis, particularly with pulmonary tuberculosis and lung tumors. Thoracic ultrasound is an accessible, non-invasive modality that is sensitive in detecting subpleural abnormalities, making it a potential effective screening tool for guiding diagnosis and intervention. Case: A 49-year-old male presented with complaints of shortness of breath, right chest pain, and weight loss. The patient had previously undergone anti-tuberculosis therapy for two months with a negative sputum culture. Chest radiography revealed pathology in the right lower lung. Thoracic ultrasound identified a hyperechoic mass with irregular borders and pleural effusion, with a guiding distance of 3.8 cm for intervention. A transthoracic needle aspiration (TTNA) was performed using a 25G Spinocan needle, resulting in 12 cytological samples. Cytology indicated C4: suspicious for malignancy. At the referral hospital, a chest CT scan confirmed a spiculated mass at the right hilum with dissemination to the pleura, pericardium, bilateral lymph nodes, and adrenal glands (T4N3M1c2). Bronchoscopy revealed infiltrative stenosis, and biopsy confirmed the diagnosis of squamous cell lung cancer. Conclusion: Thoracic ultrasound has proven beneficial in early screening and detection of subpleural masses in healthcare facilities with limited resources. This modality enhances the accuracy of early assessments and enables safe and targeted TTNA, thereby expediting the diagnosis of lung cancer and preventing delays in referral. The integration of thoracic ultrasound into the diagnostic pathway in peripheral hospitals can improve service quality and enhance patient outcomes.
Integrated Exhaled Breath VOC Profiling and Serum sICAM-1 for Biomarker Characterization in Drug-Sensitive and Drug-Resistant Tuberculosis Hustorio Aliongko Simamora; Iin Noor Chozin; Ngakan Putu Parsama Putra; Arinto Yudi Ponco Wardoyo; Ani Budi Astuti; Sastia Rakhma
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.202-211

Abstract

Introduction: Rapid, non-invasive screening for drug-resistant tuberculosis (DR-TB) is urgently needed in high-burden settings such as Indonesia, where sputum-based diagnostics have practical limitations. Integrating exhaled breath volatile organic compounds (VOCs), which reflect host–pathogen metabolic interactions, with serum soluble intercellular adhesion molecule-1 (sICAM-1), a marker of endothelial activation and inflammation, may improve early detection. This study evaluated the combined potential of VOC profiling and sICAM-1 to distinguish drug-sensitive TB (DS-TB), DR-TB, and healthy controls. Methods: A prospective cross-sectional study was conducted in four TB referral hospitals in East Java, Indonesia. Eighty-eight participants were enrolled: DS-TB (n=32), DR-TB (n=30), and healthy controls (n=26). Exhaled breath VOC profiles were analyzed using a breath analyzer, and serum sICAM-1 levels were measured by enzyme-linked immunosorbent assay. Group comparisons used ANOVA or Kruskal–Wallis tests with post hoc analyses, and correlations were assessed using Pearson or Spearman tests. Results: Serum sICAM-1 levels were significantly higher in both TB groups than in controls (p<0.01) but did not differ between DS-TB and DR-TB (p=0.961). Several VOC components differed significantly, particularly formaldehyde, acetone, and methane (CH₄). CH₄ levels were significantly higher in DR-TB than in DS-TB and controls (p<0.05). A weak negative correlation between formaldehyde and sICAM-1 was observed in DS-TB (r = −0.355; p = 0.046). Conclusion: Integrating VOC profiling with sICAM-1 assessment offers a promising non-invasive strategy for TB screening. While sICAM-1 reflects inflammatory activity, methane-based VOC signatures may improve identification of DR-TB.
Sclerosing Rhabdomyosarcoma Tumor of Anterior Mediastinum in an Adult: A Rare Case Report Ria Christin Lumpiach; Yani Jane Sugiri; Ungky Agus Setyawan; Liana Karliasari; Hendy Setyo Yudhanto
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.274-281

Abstract

Introduction: Rhabdomyosarcoma (RMS) is a malignant tumor that develops from mesenchymal cells, very rare in adults, approximately only 1-2%. Sclerosing Rhabdomyosarcoma (ScRMS) includes as newer subtypes of RMS, forming 5-10% of all RMS cases. RMS very rare occurs in the mediastinal, the predilection generally in extremity, genitourinary, head and neck region. RMS in adults has a poorer prognosis than paediatric and other high-grade sarcomas in adults. Case Presentation: A 47 years-old man with complaints of shortness of breath and left chest pain 4 months before admitted to the hospital. Thorax-CT suggests anterior mediastinal tumor with pericardial effusion, bilateral pleural effusion and venous cava superior syndrome (VCSS). The patient underwent open biopsy, radiotherapy, thoracocentesis and pericardiocentesis. Immunohistochemistry Desmin(+), CD45(-), CK(-), Myogenin(+), suggest a ScRMS dd Malignant Tryton Tumor, then H3K27Me3(+), SOX-10(-) established ScRMS. He started chemotherapy with Carboplatin-Etoposide regimen. After third series chemotherapy, RECIST CT examination showed progressive disease, patient then continued second line chemotherapy with Paclitaxel but also results to progressive disease. Conclusions: Pure mediastinal ScRMS in adults is extremely rare, with aggresive behaviour. Awareness of adults RMS is important due to its prognosis that rapidly progressive cause death and there is no standart regimen for adults RMS. Keywords: Sclerosing Rhabdomyosarcoma, Mediastinal Rhabdomyosarcoma
Urine Lipoarabinomannan and Serum C-Reactive Protein for Pulmonary Tuberculosis: A Cross-Sectional Diagnostic Accuracy Study in a Tertiary Referral Hospital Fahnida Nazliah; Yani Jane Sugiri; Tri Wahju Astuti
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.212-220

Abstract

Background: Rapid molecular tests are central to pulmonary tuberculosis (TB) diagnosis, yet sputum scarcity, pre-analytic barriers, and operational delays sustain diagnostic uncertainty in referral hospitals. Urine lipoarabinomannan (LAM) and serum C-reactive protein (CRP) may provide adjunctive, point-of-care signals, but head-to-head evidence in routine care remains limited. Methods: We conducted a cross-sectional diagnostic accuracy study in a tertiary referral hospital in Indonesia and reported according to STARD principles. Adults with suspected pulmonary TB who had not started anti-tuberculosis treatment underwent urine LAM testing and serum CRP measurement (cut-off >5). The reference standard was bacteriological testing using a rapid molecular assay on respiratory specimens. We calculated sensitivity, specificity, predictive values, likelihood ratios, and receiver operating characteristic (ROC) area under the curve (AUC). Results: Fifty participants were included with complete index and reference test data. Urine LAM demonstrated sensitivity 78% and specificity 75%, with PPV 56.7% and NPV 75% (LR+ 3.12; LR− 0.29) and AUC 0.77. CRP showed sensitivity 75% and specificity 50%, with PPV 58.1% and NPV 68.4% (LR+ 1.50; LR− 0.50) and AUC 0.62. LAM and CRP distributions did not differ significantly between clinically diagnosed and bacteriologically confirmed TB groups (p=0.056 and p=0.072, respectively). Formal AUC comparison and subgroup analyses were not performed because of limited granularity and few HIV-positive participants. Conclusion: In this referral hospital cohort, urine LAM provided better overall discrimination and stronger rule-in support than CRP, while CRP appeared more suitable for triage-oriented use. Multicenter studies should validate these findings and test combined algorithms for implementation in practice.
Revisiting Pleural Effusion Classification: Diagnostic Utility of the Serum-Effusion Albumin Gradient Compared with Light’s Criteria Chairunnisya Chairunnisya; Ricke Loesnihari; Andika Pradana
Jurnal Respirasi Vol. 12 No. 3 (2026): September 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.3.2026.221-228

Abstract

Introduction: Pleural effusion is a common clinical condition resulting from various systemic or local diseases. Differentiating transudative from exudative effusions is essential for determining etiology and management. Light’s criteria remain the standard diagnostic method; however, their accuracy may decrease in certain conditions, such as in patients receiving diuretic therapy. The Serum–Effusion Albumin Gradient (SEAG) has been proposed as a simpler parameter with potential diagnostic value Objective: To evaluate the diagnostic performance of SEAG in differentiating transudative and exudative pleural effusions using Light’s criteria as the reference standard Methods: This cross-sectional analytic study was conducted at Adam Malik Hospital, Medan, from October to December 2025. Sixty-three patients with pleural effusion undergoing thoracentesis were enrolled consecutively. Statistical analyses included the Mann–Whitney test, Chi-square test, Cohen’s Kappa for agreement, and Receiver Operating Characteristic (ROC) curve analysis to determine the optimal cut-off, sensitivity, and specificity of SEAG Results: Based on Light’s criteria, 58.7% of effusions were classified as exudates and 41.3% as transudates. SEAG classified 60.3% as transudates and 39.7% as exudates. A significant association was found between SEAG and Light’s criteria (χ² = 23.753; p < 0.001) with moderate agreement (κ = 0.571; p < 0.001). ROC analysis showed an AUC of 0.813 (95% CI: 0.704–0.923). The optimal SEAG cut-off was 1.295 g/dL, with 92.3% sensitivity and 73% specificity Conclusion: SEAG demonstrated good diagnostic performance and may serve as an additional parameter in differentiating pleural effusions Keywords: Pleural effusion, SEAG, Light’s criteria, transudate, exudate, quality of care

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