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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 14 Documents
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Search results for , issue "Vol. 9 No. 2 (2023): May 2023" : 14 Documents clear
Deciphering the Coagulation Factors in Pulmonary Embolism Incident-Based Thorax Enhanced Chest CT in COVID-19 Patient Wan Betty Pratiwi; Noni Novisari Soeroso; Setia Putra Tarigan; Muntasir Abdullah; Rosita Juwita Sembiring; Azizah Ghanie Icksan; Netty Delvrita Lubis; Putri Chairani Eyanoer
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.93-100

Abstract

Introduction: Pulmonary embolism is associated with coagulopathy in COVID-19. It is one of the causes of death in COVID-19 cases and is often underdiagnosed in Indonesia because computed tomography-pulmonary angiography (CTPA) is not used as the gold standard. T Methods: This study used a prospective analytical design with a cross-sectional approach. The study participants were 45 COVID-19 patients admitted to Santa Elisabeth Hospital, Medan, from January to March 2021.  Patients were identified with moderate to severe degrees of COVID-19 and elevated D-dimer and subsequently instructed to undergo a thorax CT scan with IV contrast. The data was analyzed using dependent t-test statistical analysis. The p-value < 0.05 was noted as significant. Results: Moderate to severe coagulation factor values in COVID-19 patients with mean + SD PT, APTT, D-dimer, fibrinogen, and platelets were 14.11; 30.65; 1172.14; 423.56 and 215.822, respectively. In this study, 22 (48.9%) patients experienced a pulmonary embolism, while the other 23 (51.1%) did not. No significant correlation was found between all coagulation factors and embolism (p > 0.05). The mean + SD well score for pulmonary embolism was 0.23 + 0.57. Conclusion: Pulmonary embolism was detected in 22 patients (48.49%) with moderate to severe COVID-19 who developed hypercoagulation as indicated by the thorax CT scan with IV contrast. This case was quite common. In resource-constrained situations, a thorax CT scan with IV contrast may replace CTPA in diagnosing/detecting the presence of pulmonary embolism.
Survival Analysis of Lung Adenocarcinoma Patients with Exon 19 Del and 21 L858R Mutations Receiving EGFR-TKI Treatment Stephen Johan Prasetyo; Noni Novisari Soeroso; Setia Putra Tarigan; Erna Mutiara; Novia Nurul Faizah
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.101-107

Abstract

Introduction: Patients with adenocarcinoma of the lung that have a common EGFR mutation, the Exon 19 Del mutation, survive better than those with the Exon 21 L858R mutation. This study examined whether there is a significant difference in prognosis between two common EGFR mutations, namely exon 19 Del and 21 L858R. This study compared OS (overall survival) and PFS (progression-free survival) in NSCLC patients with Exon 19 Del and Exon 21 L858R mutations who received EGFR-TKI targeted therapy at H. Adam Malik Hospital Medan. Methods: This analysis study used a retrospective cohort design to evaluate the OS and PFS of NSCLC patients who underwent EGFR-TKI precision medicine at H. Adam Hospital Malik Medan between January 1, 2017, and December 31, 2020 and also had Exon 19 Del and Exon 21 L858R alterations. Results: A total of 88 people were sampled. The majority of research subjects were male (60.2%). Median OS was eleven months (95 percent CI:9.594-12,406). According to the study's data, eight people (9.1%) survived until the study's ending. The median OS of Exon 19 Del Common Mutation was 11 months (95%CI 9,064-12,936). While Exon 21 L858R group had ten months (95%CI 4,546-15,454). The log-rank test identified no statistical difference in median OS between mutation types (p=0.562). Conclusion: The findings of this study revealed that subjects with Exon 19 Del mutations had a longer median OS and PFS than those with Exon 21 L858R variants. Nevertheless, there was no significant difference in median OS and PFS between study subjects with mutation of Exon 19 Del and Exon 21 L858R, which received the targeted medication.
Breathing and Light- to Vigorous-Intensity Aerobic Exercises Improved Respiratory Functions and Functional Capacity of COVID-19 Survivor with Morbid Obesity Arnengsih Nazir; Agung Budi Sutiono
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.124-129

Abstract

Introduction: A decrease in respiratory functions (RF) and functional capacity (FC) may present as complications of intensive care unit (ICU) admission. Morbid obesity worsens these complications. Case: A 31-year-old male patient with morbid obesity came for pulmonary rehabilitation (PR) one week after hospitalization. He suffered from COVID-19 and received 15 days of mechanical ventilation. The goal of PR was to improve RF and FC. A comprehensive PR, including hospital- and home-based programs, consisting of breathing, aerobic, resistance, and flexibility exercises, diet and psychological counseling was given. Breathing exercises were deep breathing, sustained-maximal breathing, and chest expansion. Hospital-based PR was given with moderate-intensity interval aerobic exercise (AE), while home-based PR was with low-intensity continuous, both with oxygen supplementation. The FC was needed to do his daily activities, and vocational was 1.0 to 6.3 metabolic equivalents (METs). The target of FC 6 METs in 12-18 weeks was set. After six weeks, the RF improved with decreased dyspnea and increased maximum inspiratory volume and chest expansion. The FC increased to 4.2 METs, and monitored-home-based AE was given with vigorous-intensity interval mode. He joined the residency program 10 weeks later and achieved 5.7 METs at the end of PR. We gave unsupervised home-based exercises for his long-term exercise. Conclusion: Breathing and AE improved RF and FC in a COVID-19 patient with morbid obesity admitted to the intensive care unit (ICU) to previous vocational activities.
Prevalence of Lung Cancer with a History of Tuberculosis Nadira Putri Nastiti; Laksmi Wulandari; Sulistiawati Sulistiawati; Anna Febriani; Wiwin Is Effendi
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.87-92

Abstract

Introduction: Lung cancer ranks as the second most common diagnosis of malignancy cases in the world with the highest mortality, while Indonesia is the country with the largest tuberculosis (TB) burden after India. Although these two diseases have a high incidence and mortality rate and are one of the main causes of health problems, coexistence between these two diseases is very rare. A similar clinical and radiological feature complicates the diagnosis and worsens the prognosis. This study aimed to determine the prevalence and distribution patterns of lung cancer incidence with a history of TB. Methods: This was a descriptive study. The data were obtained retrospectively from the electronic medical records of lung cancer patients from one roof oncology clinic, Dr. Soetomo General Hospital, Surabaya, in 2018–2020, meeting the inclusion and exclusion criteria. Results: Specifically, 76 out of 1,044 (7.3%) lung cancer patients had a history of TB, with the distribution being men (71.1%), in an age range of 50-59 years old (34.2%), who were active smokers (36.9%), had an adenocarcinoma type of cancer (90.8%), had a positive EGFR gene mutation (50%), and had a diagnosis of non–small cell lung cancer (NSCLC) during stage IV (79%) after a TB diagnosis (54%) with a time interval of 1 or >10 years. Conclusion: The prevalence of lung cancer with a history of TB was 7.3%. Lung cancer screening is important in TB patients after one or even >10 years of diagnosis to reduce the morbidity and mortality rates because of this risk of coexistence.
Volatile Organic Compounds (VOCs) and Interleukin-23 Levels in Lung Cancer: A Future Biomarker Raden Dicky Wirawan Listiandoko; Ungky Agus Setyawan; Tri Wahju Astuti; Susanthy Djajalaksana; Aditya Sri Listyoko; Arinto Yudi Ponco
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.80-86

Abstract

Introduction: Lung cancer (LC) is the world's second leading cause of death due to malignancy. In Indonesia, LC is one of the top three malignancies. Volatile organic compounds (VOCs) from the respiratory reflect changes in metabolism caused by disease and may be a biomarker of LC. Interleukin-23 (IL-23) has been known as a pro-inflammatory cytokine in the development and progression of cancer. This study aimed to identify levels of IL-23 and VOCs in LC patients. Methods: This study involved 40 LC patients and 42 controls. VOCs were taken by the subject exhaling their third deep breath into the sample bag, which was immediately analyzed using an E-nose-based device. As for the IL-23, the cytokine was taken from the blood serum and then analyzed using the ELISA method. Kolmogorov-Smirnov and Shapiro-Wilk tests were performed to test data normality. Mann-Whitney and Kruskal Wallis tests were conducted for variables. Spearman correlation and heat map were used to find the correlation between the observed gases and IL-23. Results: The concentration of ozone (p = 0.000), ethanol (p = 0.000), formaldehyde (p = 0.000), toluene (p = 0.000), acetone (p = 0.000), ammonia (p = 0.000), ammonium (p = 0.001), nitrogen (p = 0.001) and methane (p = 0.000) in LC group differed with controls. The same outcome was also observed in comparing LC patients and control groups of IL-23 (p = 0.000). Spearman correlation analysis revealed a positive correlation between serum IL-23 with formaldehyde (p = 0.029), toluene (p = 0.014), and ammonia (p = 0.028) and a negative correlation with nitrogen (p = 0.011). Compared to the control group, all types of LC were observed to have higher levels of IL-23. A weak positive correlation was found in formaldehyde (Cv = 0.23), toluene (Cv = 0.23), and ammonia (Cv = 0.13). A weak negative correlation was obtained in acetone (Cv = -0.12), ammonium (Cv = -0.11), and nitrogen dioxide (Cv = 0.23). Conclusion: Weak linear correlations were obtained between the cytokine and formaldehyde, toluene, ammonia, ammonium, and nitrogen dioxide. A higher IL-23 concentration was observed in the LC group than in the control group. The volatile concentration was significantly different between LC and control groups.
Diagnostic Approach of Lung Cancer: A Literature Review Jesi Hana; Novia Nurul Faizah
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.141-149

Abstract

Lung cancer is the second most commonly diagnosed malignancy with the highest mortality rate. It can be classified into small-cell lung carcinoma (SCLC) and non-small-cell lung carcinoma (NSCLC). At the early stage of the disease, lung cancer rarely gives apparent symptoms. Patients are usually diagnosed at an advanced stage. Lung cancer is closely related to tobacco smoking. The increasing prevalence of tobacco smoking in Indonesia should be an alarm. During the last decades, knowledge and technology regarding lung cancer screening and diagnosis have vastly increased. Proper screening for high-risk individuals will help to increase the survival rate from the disease. Diagnosis of lung cancer using various radiologic modalities, histopathology, and biomolecular tests will also determine a specific treatment approach for the patient. A proper diagnostic test will also help predict the patient's prognosis. This literature review aimed to provide foundation knowledge from recent guidelines for screening and diagnosing lung cancer.
Swine Flu (Influenza A, H1N1pdm2009) Infection on an Elderly Patient with Chronic Obstructive Pulmonary Disease (COPD): A Case Report Anak Agung Bagus Bramardipa; Anak Agung Gde Upeksha
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.136-140

Abstract

Introduction: Influenza is one of the most common causes of respiratory illness in the world. In April 2009, a novel H1N1 virus of swine origin was spreading among individuals, and within days became a pandemic, called H1N1pdm2009. Years after the pandemic, H1N1pdm2009 is now a common seasonal flu that manifests as flu-like symptoms just like other influenza. Swine flu is a self-limiting disease that doesn't need necessary antiviral treatment unless it displays moderate presentation or in an individual with comorbidities. Case: A 71-year-old man came to the emergency room with a chief complaint of shortness of breath. Symptoms started with common flu one week before admission and worsened prior the admission date. In the emergency room, patient looked lethargic, tachypnea, and low saturation, his oxygen saturation was 88% on room air and 99% using a non-rebreathing mask of 8 liters per minute. Ronchi was heard on both sides of the lungs. He has regular visits for his chronic obstructive pulmonary disease (COPD). Multiple investigations were done including thorax imaging, complete blood count and naso-orofaring PCR. Swab results indicated an influenza-A H1N1pdm2009 infection with no COVID-19 co-infection. During hospitalization, patient received a 75 mg dose of oseltamivir twice a day and other supportive treatment. The patient was discharged after five days of oseltamivir therapy with an improvement in conditions. Conclusion: Swine flu manifestation is similar to another influenza; however, in patients with comorbidities this virus can show moderate or severe presentation. Oseltamivir administration was given for five days and helped to improve the patient's condition.
Interleukin-6 and Neutrophil–Lymphocyte Ratio in Predicting Outcome of Confirmed COVID-19 Patients Harsini Harsini; Jatu Aphridasari; Artrien Adhiputri; Agung Prasetyo; Hie Sukiyanto; Aditya Sri Listyoko
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.108-116

Abstract

Introduction: COVID-19 emerged as a pandemic about 2 years ago. Severe and critical COVID-19 has been associated with increased interleukin 6 (IL-6) level and neutrophil–lymphocyte ratio (NLR). This study aimed to test whether IL-6 and/or NLR are associated with COVID-19 mortality. Methods: Subjects were COVID-19 patients with suspected Omicron variant infection that were hospitalized at Dr. Moewardi Hospital from October 2021 to March 2022. According to their medical records, subjects were divided into survivor and non-survivor groups. Serum level of IL-6 and NLR at admission were recorded, compared, and analyzed for association with mortality. Results: Seventy-four respondents, average age 53.07 ± 16.2 years, joined the research. The area under curve (AUC) value of IL-6 was 0.740, with a cut-off value of 42.00 mg/dL (73.9% sensitivity; 70.6% specificity). The AUC value of NLR was 0.721, with a cut-off value of 5.51 (73.9% sensitivity; 60.8% specificity). IL-6 had a higher odds ratio than NLR as a risk factor for mortality (6.80 [95% CI 2.24–20.61; p < 0.001]; 4.39 [95% CI 1.48–13.03; p < 0.001], respectively). The correlation between IL-6 and NLR had an r-value of 0.164 (p = 0.164). Conclusion: There was no difference in sensitivity between IL-6 level and NLR as mortality predictors of COVID-19, but serum IL-6 level was more specific. IL-6 level correlated positively with NLR, but there was no significance.
Air Pollution and Lung Cancer Ida Ayu Jasminarti Dwi Kusumawardani; Putu Gita Indraswari; Ni Luh Gede Yoni Komalasari
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.150-158

Abstract

Malignant lung cancer is the leading cause of cancer-related death worldwide. Smoking is the main risk factor for lung cancer. However, the International Agency for Research on Cancer (IARC) declared in 2013 that outdoor air pollution is a substance that is carcinogenic and contributes to lung cancer. This was supported by several studies which show an increased prevalence of adenocarcinoma, even in countries with a low prevalence of smokers. The presence of one or more substances in the air for longer periods or at higher concentrations than usual, which can potentially have negative effects, is called air pollution. Aside from carbon monoxide (CO), nitrogen dioxide (NO2), lead, ozone (O3), and sulfur dioxide (SO2), particulate matter with <2.5 µm diameter (PM2.5) has been identified to be associated with the risk of lung cancer. The risk of lung cancer was higher after prolonged exposure to PM2.5 regardless of age, gender, and smoking history. Exposure to air pollution is a significant factor in the onset and progression of lung cancer. Oxidative stress, deoxyribonucleic acid (DNA) damage, inflammation, metabolism, epigenetic control, and signal transduction pathways are a few potential mechanisms of air pollution-induced lung cancer. Everyone, including the government and the general public, must implement strategies to stop the harmful effects of air pollution.
Pathological Characteristics of Fiberoptic Bronchoscopy Procedure in Ulin General Hospital, Banjarmasin Ira Nurrasyidah; Muhammad Ajib Nuzula; Ika Kustiyah Oktaviyanti; Desi Rahmawaty; Tenri Ashari Wanahari
Jurnal Respirasi Vol. 9 No. 2 (2023): May 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.2.2023.117-123

Abstract

Introduction:  Fiberoptic Bronchoscopy (FOB) has emerged into the method of choice for the detection of lung tumors due to its availability of Adequate cytological and histological samples in the form of broncho-alveolar lavage, bronchial brushings, and bronchial forceps biopsy. This study aims to identify characteristics of bronchoalveolar lavage, aspiration cytology, brushing cytology and forceps cytology of patients suspected with malignancy at the Ulin Regional Hospital in South Kalimantan. Methods: A cross-sectional study was carried out utilizing medical documentation of patients suspested lung cancer from March 2018 to March 2020. Data were grouped by gender, age, type of procedure, and cytology and histopathology findings. Results: The result showed that 67.5% of 117 patients who underwent bronchoscopy had positive results and common histological diagnosis The frequent histopathological conclusion was adenocarcinoma (45.6%) tailed by squamous cell carcinoma (40.55). Forceps bronchoscopy showed a greater positivity rate (75.0%) than bronchoscopy without forceps (63.6%), we also found that by combining BAL and brushing and forceps biopsy, the detection rate of lung malignancy increased to 85.7%, but no correlation between the type of procedure and the likelihood of malignancy was discovered. Conclusions: Forceps bronchoscopy showed a greater positivity rate than bronchoscopy without forceps, but no correlation between the type of procedure and the likelihood of malignancy was discovered in our study.

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