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Jurnal Respirasi (JR)
Published by Universitas Airlangga
ISSN : 24070831     EISSN : 26218372     DOI : -
Core Subject : 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.
Arjuna Subject : -
Articles 334 Documents
The Role of Macronutrients in Chronic Obstructive Pulmonary Disease: A Review Kristy, Anastasia; Hardian, Harris; Putra, Wayan Wahyu Semara; Yaniswari, Ni Made Dwita; Tania, Tryna
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.161-167

Abstract

The incidence of chronic obstructive pulmonary disease (COPD) is rising and is still regarded as one of the challenging medical issues. Regardless of the main relationship between tobacco smoking and toxic particle exposure with COPD, factors like nutritional status also play an important role in COPD progression and outcome, as the factor is an adaptable aspect. Malnutrition, sarcopenia, and obesity are nutritional problems that are often encountered in COPD patients. Macronutrients, namely carbohydrates, fat, and protein, support the adjunctive treatment options for COPD. The ideal dietary pattern includes low carbohydrates, medium fats preferably polyunsaturated fatty acids (PUFA), and high proteins to improve COPD symptoms, preserve muscle mass, and delay disease progression. High carbohydrate intake might also increase the respiratory quotient (RQ) which results in higher carbon dioxide (CO2) production and oxygen (O2) demand compared to fat and protein intake. Daily calorie intake should be adjusted to personal nutritional status. Higher calories in malnourished, sarcopenic patients and targeted weight loss in obese patients show improvements in lung function, frequency of exacerbations, and hospitalization rate. In obese individuals with COPD, however, maintaining a slightly higher body mass index (BMI) of 25-30 kg/m2 was associated with lower mortality. This literature review summarized the significant role of macronutrients in COPD patients and the practical approach to macronutrient intervention in individuals with different nutritional statuses.
Antibiotic Susceptibility Patterns among Indonesian Adults Hospitalized with Pneumonia Akhmad, Afan Fatkhur; Ulfa, Maria; Azuma, Momoyo
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.6-13

Abstract

Introduction: Pneumonia continues to be a global issue with significant morbidity and mortality rates. Increased multidrug-resistant (MDR) bacterial pneumonia, aging populations, chronically ill patients, and inadequate initial antibiotic therapy increase hospitalized pneumonia patients' morbidity and mortality. This study aimed to analyze the microbiological pattern and choose a therapy based on local antibiotic susceptibility patterns. Methods: From January 2020 to December 2022, a retrospective cross-sectional study was conducted on hospitalized pneumonia patients at Haji General Hospital, Surabaya, Indonesia. Data from medical records were gathered to illustrate patient features, bacterial culture, and antimicrobial susceptibility tests. This study included 172 patients. In this study, no specific statistical analysis was performed. The data were reported as a percentage (%).  Results: The patients were mostly 56-65 years old (36.6%) and male (55.2%). The most common comorbidities were cardiovascular disease (17.3%), and the others were diabetes mellitus (14.0%), cerebral vascular attack (CVA) (10.7%), and coronavirus infection (8.9%). Based on the sputum culture, the bacteria identified were Klebsiella pneumoniae (25.0%), Pseudomonas aeruginosa (20.9%), Acinetobacter baumannii (15.7%), and Escherichia coli (11.6%).  The most common bacteria isolated from sputum cultures was Klebsiella pneumoniae, which was more susceptible to amikacin and meropenem.  Conclusion: Only amikacin was an antibiotic susceptible to four primary pathogens. Rates of resistance to ciprofloxacin and ceftriaxone were high, and these empiric antibiotics should be used with caution in these patients.
The Role of Genome-Wide Association Study in Pulmonary Disease Diagnostics: A Review in Medical Bioinformatics Andromeda, Rossalyn; Pratomo, Irandi Putra; Fauzi, Ahmad; Kinasih, Tutug; Prasenohadi, Prasenohadi; Santoso, Arif; Tokumo, Kentaro
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.76-84

Abstract

Biomedical science, which initially required only conventional research in the laboratory, currently involves information technology and has created bioinformatics in its development. Bioinformatics, a branch of biology, quantitatively analyzes information within biological macromolecules using software. Contemporary applications of bioinformatics have advanced biotechnological, medical, and pharmaceutical practices. Among the established applications of bioinformatics is diagnosing lung diseases using the genome-wide association study (GWAS) technique. Owing to sequencing technology and rapid computational methods, this technique is applied to analyze the link between genes with essential traits in the population, thus mapping the target genes to diagnose and treat diseases. The lung diseases diagnosed using GWAS include the responsible locus in asthma, chronic obstructive pulmonary disease (COPD), and lung cancer. Moreover, it can identify the treatment for COPD and suggest a new locus in lung cancer. Advancing the current gene-mapping technology demands genotype and phenotype data to study disease-linked genomes. Currently, bioinformatics is barely known and receives little attention in Indonesia. However, it can grow rapidly through open-source basis data and cross-disciplinary collaboration.
D-Dimer and Brixia Score to Mortality in COVID-19 Patients Falyani, Silvy Amalia; Pratiwi, Suryanti Dwi; Setyawan, Ungky Agus; Erawati, Dini Rachma; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.99-106

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) is a highly contagious severe and acute respiratory syndrome caused by the SARS-CoV-2 virus. A variety of factors can increase a patient's risk of death, including coagulopathy characterized by increased D-dimer levels. Brixia scores could be one of the determinants of COVID-19 severity, as assessed by chest radiographs. This study aimed to analyze chest radiographic severity based on the Brixia score at the degree of coagulation based on D-dimer in mortality of COVID-19 patients who were hospitalized. Methods: This cohort retrospective study was conducted at Dr. Saiful Anwar General Hospital, Malang, using an observational cross-sectional design. The study included 300 medical records of COVID-19 patients who passed away while hospitalized. The data were analyzed using the Wilcoxon test, and the results were also tested for Spearman correlation to determine the relationship between variables. Results: Significance results of median D-dimer were found by age and severity of COVID-19 (p-values 0.015 and 0.002), and median Brixia scores by age, gender, severity of COVID-19, and length of treatment (p-values 0.001, 0.001, 0.001, and 0.005). The results were also compared with normal values, which were significant (p = 0.000). Spearman correlation test results between the final D-dimer and the initial Brixia score (p = 0.005). Conclusion: The research results display a retrospective study of the correlation between D-dimer and Brixia score values "‹"‹and outcomes in COVID-19 patients. Higher D-dimer values"‹ "‹and Brixia scores on admission were shown to be associated with mortality.
Vitamin D, Body Mass Index, and Total Lymphocyte Count in Drug-Sensitive and Drug-Resistant Tuberculosis Patients in Banjarmasin Riefani, Soraya; Juhairina, Juhairina; Isa, Mohamad; Kusumawardhani, Erna; Haryati, Haryati; Syam, Shaogi; Nurrasyidah, Ira
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.14-22

Abstract

Introduction: Tuberculosis (TB) remains a global health problem that causes high morbidity and mortality. Based on its classification, TB is divided into drug-sensitive (DS) and drug-resistant (DR). Several risk factors susceptible to TB are malnutrition with low body mass index (BMI), vitamin D deficiency (VDD), and low total lymphocyte count (TLC) related to low immune status. This study aimed to examine the relationship between vitamin D (VD), BMI, and TLC in the TB population in Banjarmasin. Methods: This was an analytic observational study with a cross-sectional design. The total study sample was 42 patients, confirmed by rapid molecular testing, who had not been treated for TB in Banjarmasin from January to May 2023 and met the inclusion and exclusion criteria. Chi-Square and Fisher's exact statistical tests were used to see the relationship between VD, BMI, and TLC in DS TB and DR TB. Results: The median age of DS TB was 38 (24-52) years old, and DR TB was 51 (37-58) years old. Most of the gender was male (24 patients/57.1%). There was a statistically significant difference between VD and BMI in DS TB and DR TB (p = 0.048; p = 0.019). There was a significant relationship between VD and TLC in DS TB and DR TB (p = 0.048). Conclusion: VD and BMI significantly differed in DS TB and DR TB. There was a significant correlation between VD and TLC in TB patients.
Comparison of Forced Expiratory Flow (FEF) 25-75% between Post-COVID-19 Patients with Different Severity at Universitas Gadjah Mada Academic Hospital Khidir, Muhammad; Siswanto, Siswanto; Rasena, Henda Ageng; Iqbal, Roihan Mohamad; Sabirin, Rahmaningsih Mara; Wibowo, Rakhmat Ari; Rasyid, Sani Hadiyan
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.23-29

Abstract

Introduction: Shortness of breath is the most distressing long COVID-19 symptom associated with the decline of small airway function, as shown by a decrease in forced expiratory flow (FEF) 25-75% value in the spirometry test. This study aimed to compare FEF 25-75% values as a predictor of small airway disease between mild-moderate and severe-critical long COVID-19 patients. Methods: This study used a prospective cohort design that included 24 post-hospitalized COVID-19 patients who came to the long COVID-19 clinic at Universitas Gadjah Mada Academic Hospital (UGM AH), Yogyakarta. The subjects were divided into mild-moderate and severe-critical groups based on the World Health Organization (WHO) classification. The subjects were tested for spirometry three months after the onset of COVID-19 symptoms. The comparison of both severity groups used the percent prediction of FEF 25-75% spirometry results. The value was interpreted as abnormal if the predicted FEF 25-75% value was below 65%. Results: There were three (25%) and two (16.67%) subjects with FEF 25-75% predicted below normal values in the mild-moderate and severe-critical groups consecutively, which showed a decline in small airway function. This study showed no statistically significant differences (p-value = 0.882) between the means of FEF 25-75% predicted values of the two groups. Conclusion: A small proportion of post-COVID-19 syndrome patients had small airway disease, and there were no statistical differences in small airway function between the groups.
Thymoma Profile at Dr. Moewardi General Hospital: Does Thymoma Size Really Affect Distant Metastasis? Thomas, Novita Silvana; Fahlevie, Fahlevie; Setijadi, Ana Rima; Widiastuti, Widiastuti; Rakhma, Sastia
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.30-35

Abstract

Introduction: Size is a predictor factor of a patient's prognosis and metastasis in solid tumors. This study determined the relationship between thymoma size and distant metastasis. Methods: A cohort retrospective study using medical record data was conducted at Dr. Moewardi General Hospital, Surakarta, from January 2019 to August 2021. Of 1,430 thoracic oncology patients, 150 (10%) had mediastinal mass with thymoma as the majority (48.6%). About 73 thymoma patients were included. The size of the thymoma was the dependent variable, and the metastasis (distant and non-distant) was the independent variable. The cut-off point of thymoma size was determined with receiver operating characteristic (ROC) analysis. The correlation of thymoma size with distant metastasis was analyzed with the Chi-Square test, and p < 0.05 was considered significant. Results: Thymoma was predominated by males (53.4%), the mean age was 43 ± 16 years old, and dyspnea was the most common symptom. Metastatic lesions were found in 87.7% of the patients, and the most common metastatic sites were intrathoracic (79.5%), followed by axillary lymph nodes (49.3%), bone (21.9%), liver (20.5%), and brain (1.4%). The cut-off value of thymoma size was 8.25 cm, indicating that >8.25 cm was categorized as large thymoma. Distant metastasis was found in 86.0% of large thymoma patients. The large tumors tend to spread into various sites (OR = 5.39; 95% CI 2.8-32.6; p = 0.002).   Conclusion: Thymoma must be taken into account when there are male patients in their forties presented with dyspnea and mediastinal mass. The cut-off point of 8.25 cm for the thymoma size can predict distant metastasis.
Effects of Upper Arm and Breathing Exercise on Interleukin-6 in COVID-19 Patients Tarigan, Amira Permatasari; Listyoko, Aditya Sri; Pandia, Pandiaman; Pradana, Andika; Eyanoer, Putri Chairani; Sinaga, Sudirman Parningotan; Vera, Yeni; Firdaus, Ruby; Ramadhani, Adini Arifah
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.36-41

Abstract

Introduction: COVID-19 disease has become a comprehensive world issue and has been declared a significant threat to global health. Interleukin-6 (IL-6) is an important inflammatory marker and one of the triggers of the cytokine storm in COVID-19, where increased levels can be an independent predictor of COVID-19 mortality. This study aimed to observe the effect of upper arm and breathing exercises on IL-6 levels in severe COVID-19 patients. Methods: The study design was quasi-experimental, with blood tests conducted before and after the examination. A total of 20 patients with confirmed COVID-19 were involved, divided into intervention and control groups. Results: Blood tests to determine baseline IL-6 levels were performed in all patients. Patients from the intervention group were given upper arm and breathing exercises for ten days, twice a day, via video tutorials on mobile phones, while patients from the control group did not receive any exercises. Patients from the intervention group obtained mean pre- and post-exercise IL-6 levels of 42.38 ± 48.48 and 16.78 ± 18.29, respectively (p = 0.005). Conclusion: Upper arm and breathing exercises showed significant changes in IL-6 levels in severe COVID-19 patients.
Emerging Role of Precision Medicine in Diagnosis and Treatment of Chronic Respiratory Disease Wesnawa, Made Agustya Darma Putra; Asmara, Oke Dimas; Supadmanaba, I Gede Putu
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.85-92

Abstract

Precision medicine is the current approach to managing chronic respiratory diseases, especially asthma and chronic obstructive pulmonary disease (COPD). It involves the evaluation of genetic, environmental, and lifestyle variations for each patient. It requires valid and specific biomarkers obtained through genetic studies, biomolecular technology, and omics-based technology to determine targeted therapies. Asthma and COPD have heterogeneous clinical phenotype variations, and giving one standard treatment for asthma and COPD may not necessarily provide the same effectiveness to other patients. The endotype, a specific molecular mechanism in disease pathogenesis, is essential in phenotype variation. The role of precision medicine in asthma and COPD is to determine endotypes through specific biomarkers and to provide specific targeted therapy for achieving personalized treatment in each patient. The application of precision medicine not only provides precise diagnosis and treatment but also enables early detection in individuals at risk and prevention of progression and exacerbation in asthma and COPD.
P/F Ratio is a Better Predictor for Non-Invasive Ventilation Failure and Length of Stay in Patients with Community-Acquired Pneumonia Hapsari, Brigitta Anindita Devi; Roxanne, Olivia Geraldine; Reviono, Reviono; Adhiputri, Artrien; Apriningsih, Hendrastutik; Rahayu, Nur Indah; Vagheggini, Guido
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.42-49

Abstract

Introduction: Community-acquired pneumonia (CAP) can deteriorate into respiratory failure requiring immediate ventilatory intervention. This study compared the performance of the PaO2/FiO2 (P/F) ratio, the ratio of oxygen saturation (ROX) index, and the heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) score in predicting non-invasive ventilation (NIV) failure and length of hospital stay in patients diagnosed with CAP. Methods: This study was conducted at Universitas Sebelas Maret Hospital, Surakarta, from March to September 2023. All patients diagnosed with CAP who were eligible for NIV were recruited. Each patient's age, sex, comorbidities, vital signs, pneumonia severity index (PSI), blood urea, bilirubin, hematocrit, blood sodium, P/F ratio, ROX index, and HACOR score were measured within the first 24 hours of NIV. Subsequently, the correlations between these variables and NIV failure (intubation or mortality) and length of hospital stay were assessed. Results: The P/F ratio, ROX index, and HACOR score were not correlated with intubation or length of stay. The P/F ratio was correlated with mortality (p = 0.040), whereas the other scores were not. Higher body temperature was correlated with intubation (p = 0.032). PSI was correlated with both mortality (p = 0.033) and length of hospital stay (p = 0.009). Conclusion: The P/F ratio is superior to the ROX index and HACOR score in predicting mortality in patients with pneumonia-related respiratory failure treated with NIV. Since it is simple and accessible, measuring the P/F ratio within the first 24 hours of NIV is recommended to identify a patient's risk of NIV failure and apply appropriate monitoring.