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Yolanda Handayani
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INDONESIA
Respiratory Science
Published by Perhimpunan Dokter Paru Indonesia
ISSN : -     EISSN : 27471306     DOI : https://doi.org/10.36497/respirsci.v1i3.17
Core Subject : Health,
Health Professions Medicine & Pharmacology
Focuses on original article reviews and case reports in pulmonary and critical care medicine Scope: 1. Asthma 2. Chronic Obstructive Pulmonary Disease (COPD) 3. Lung Physiology and Sleep-Related Disorder 4. Lung Infection 5. Thoracic Oncology 6. Interstitial Lung Disease 7. Environmental Lung Disease 8. Tobacco Control 9. Occupational Pulmonary Disease 10. Pulmonary Intervention and Emergency Medicine 11. Respiratory critical care 12. Respiratory immunology and biomolecular
Arjuna Subject : Kedokteran - Kedokteran Paru dan Pernafasan
Articles 108 Documents
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Immunopathogenesis of Pneumocystis Pneumonia (PCP) and Its Clinical Implications Malik, Andi Sri Suryani; Agustin, Heidy; Nurwidya, Fariz; Rozaliyani, Anna
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.172

Abstract

Pneumocystis pneumonia (PCP) is a serious lung infection caused by Pneumocystis jirovecii, primarily affecting immunocompromised individuals. It remains a major health concern, especially in HIV/AIDS patients and those undergoing immunosuppressive therapy. This review discusses how the immune system responds to P. jirovecii and why immunocompromised individuals are more vulnerable. In healthy individuals, CD4+ T cells, B cells, and macrophages help control the infection. However, in immunocompromised individuals, a weakened immune response allows fungal overgrowth, leading to severe lung damage. The review also covers symptoms, diagnosis, and treatment options. TMP-SMX is the preferred treatment, while alternative drugs are available for those who cannot tolerate it. Understanding the immune response to PCP can help improve treatment and patient care.
Severity of Obstruction Associated with Pulmonary Hypertension in COPD Patients at Arifin Achmad General Hospital: What Factors Influence? Edra, Alven; Syamsu, Adrianison; Siswanti, Dyah
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.173

Abstract

Background: Pulmonary hypertension can occur in stable chronic obstructive pulmonary disease (COPD) patients despite its unknown etiology or as a complication associated with other processes. Pulmonary hypertension was divided into five broad categories, including processes with common pathogenic mechanisms. The true incidence of pulmonary hypertension in COPD is unknown, as no systematically performed screening method can be widely used in COPD patients, while the mortality rate or complications from COPD are still very high. Method: This study method was a cross-sectional study. This study was conducted on stable COPD patients who came to the pulmonary department at Arifin Achmad General Hospital to assess its association with the risk of pulmonary hypertension. Results: This study involved 77 research subjects with the highest age <65 years (64.9%) with male gender (84.4%), airflow limitation degree GOLD II (moderate) (50.6%), severe Brinkman Index (76.6%), comorbid hypertension (7.8%), Asymmetric Dimethylarginine (ADMA)0 inflammatory marker including low-risk category (77.9%) and mild echocardiographic interpretation (75.3%). The Association of COPD severity was significant to the risk of pulmonary hypertension, the degree of airflow limitation (P=0.0001) and echocardiography interpretation (P=0.0001). At the same time, there was no significant association with ADMA levels (P=0.239). The Brinkman Index of smokers (P=0.006) was an important risk factor for pulmonary hypertension. Conclusion: There was an association between COPD severity, echocardiographic interpretation and smoking status based on the Brinkman Index and the risk of pulmonary hypertension.
Improving Physical Endurance in Palliative Stage IV Lung Cancer: A Case Report Hidayati, Evi Rachmawati Nur; Akhir, Choirunnisa Yaumal; Zatirah, Irvi Addini
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.174

Abstract

Background: Lung cancer remains the leading cause of cancer-related mortality worldwide, with advanced stages often causing fatigue, reduced endurance, and impaired lung function. Pulmonary rehabilitation, including incentive spirometry exercise (ISE) and aerobic exercise, has been proven effective in improving functional capacity in patients with lung cancer, even in palliative care settings. This case report examines the effects of ISE and aerobic exercise on a stage IV lung cancer patient. Case: A 58-year-old male with stage IV lung cancer and spinal metastases experienced increased fatigue, especially after walking 500 meters. He underwent a four-weeks palliative rehabilitation program that included individualized supportive exercises (ISE) and moderate aerobic activity. Discussion: Following the completion of the program, the patient showed improvements in respiratory function, thoracic expansion, walking ability and overall performance status. His walking distance increased from 450 meters to 522 meters, and his MET score improved, indicating an enhancement in cardiovascular fitness. Despite a decline in forced vital capacity (FVC), other indicators show significant improvements in his physical function and quality of life. Conclusion: The combination of ISE and aerobic exercise proves to be an effective rehabilitation approach in improving respiratory function, physical endurance, and quality of life with stage IV lung cancer, even within the palliative care phase.
Positivity Rates of Histology Results Based on Lesion Size and Bronchus Sign in Lung Cancer Navratilova, Melfia; Aniwidyaningsih, Wahju; Soehardiman, Dicky; Prasenohadi, Prasenohadi; Alatas, Muhamad Fahmi; Elhidsi, Mia; Desiyanti, Ginanjar Arum; Reisa, Tina; Martini, Ni Putu Laksmi Ananda
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.175

Abstract

Background: Lung cancer continues to be a major cause of cancer-related deaths globally. Bronchoscopy serves as a key diagnostic tool, allowing histological sampling through transbronchial biopsy (TBB). The bronchus sign, identified on pre-biopsy CT scans, is associated with improved diagnostic yield in TBB. Method: A retrospective study was conducted between October and December 2023 at Persahabatan Hospital, Jakarta, analyzing 88 patients suspected of lung cancer. Data collected comprised patient demographics, lesion size as determined by CT scans, and the presence or absence of the bronchus sign. Fisher’s exact test was applied for statistical analysis, with a predetermined significance level of P<0.05. Results: Positive histology results were identified in 38 cases (55.07%) for lesions ≥3 cm and 9 cases (47.39%) for <3 cm(P=0.607). In lesions ≥3 cm, the positivity rate was similar between those with the presence (55.81%) and absence (53.85%) of a bronchus sign (P>0.99). In lesions <3 cm, positivity was higher with a bronchus sign (60%) than without (25%) (P=0.55). Conclusion: The bronchus sign appears to increase TBB positivity, especially in peripheral lesions <3 cm. Lesion size also appears to influence TBB yield. However, the findings were not statistically significant, likely due to small sample size and missing CT data.
Mortality Audit In COVID-19 Cases of the Omicron Variant in Persahabatan Hospital Susanto, Agus Dwi; Djasri , Hanevi
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.176

Abstract

Background: SARS-CoV-2, the virus that causes COVID-19, has mutated into various variants. Deaths in COVID-19 cases caused by the Omicron variant had the highest rate compared to other variants.  This research aims to mortality audit of the Omicron variant of COVID-19 in 2022 at Persahabatan Hospital. Method: This is a cross-sectional observational study focusing on the death audit form recommended by the official Indonesian Hospital Association. Used data from Medical Cause of Death Certificate (SMPK) and medical records of patients treated and died at Persahabatan Hospital in January-December 2022. The causes of death (COD) from the audit results were compared with SMPK. Conducted interviews with the doctor who takes care of patients to explore the root of the problem and improvement efforts. Results: Of the 568 COVID-19 patients with the Omicron variant hospitalized, 130/568 died. As many as 42.52% of the COVID-19 variant Omicron patients died from COVID-19 and 57.48% had COVID-19. The three most COD were respiratory failure, MOF and septic shock. The three underlying COD were COVID-19, bacterial pneumonia and lung cancer. The COD in SMPK and the results of the mortality audit are only appropriate for 23.62%. The best three suggestions for improving clinical management are evaluating the patient supervision/monitoring system, testing for COVID-19 antigens carried out earlier before PCR, and providing special services for COVID-19 patients with comorbid. The top three suggestions for improving hospital managerial aspects are to create and evaluate a special SOP for COVID-19 patients with comorbid, add special service facilities for COVID-19 patients with comorbid and increase ICU bed capacity and human resources. Conclusion: The COVID-19 variant Omicron patients died due to COVID-19 and had COVID-19. The three most COD were respiratory failure, MOF and septic shock. Only 23.62% of COD from SMPK were consistent with the results of the mortality audit.
Air Quality and Correlation of Exhaled Carbon Monoxide Level with Lung Function among Petrol Station Attendants in Banda Aceh Hardisa, Rika; Kurniawan, Ferry Dwi; Dianova, Sri; Yanti, Budi; Yusuf, Nurrahmah
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.177

Abstract

Background: Risks of developing respiratory diseases due to pollutant exposures at petrol stations are high. The pollutants, such as particulate matter, carbon monoxide (CO), and volatile organic compounds emitted from vehicle exhaust and gasoline vapours, may affect the lung function of petrol station attendants. This study aimed to assess the levels of particulate matter, total volatile organic compounds, and the correlation of CO level and lung function among petrol station attendants in Banda Aceh. Method: An analytical observational study with a cross-sectional design involved 114 attendants from 12 petrol stations in Banda Aceh. Lung function was evaluated using spirometry, and CO exhalation levels were measured using a Smokerlyzer. In addition, particulate matter and total volatile organic compounds levels were measured in the petrol station area using an air quality monitor. Results: Most participants were male (82.5%) with a mean age of 30 years. The duration of work was under 5 years in 68 participants (59.6%). Approximately 61.4% (70 samples) were active smokers, with the most common Brinkman index indicating mild smoking habits for 50 samples (43.9%). The Pearson chi-square test revealed no significant relationship between CO exhalation levels and decreased lung function (P=0.118). The level of TVOC exceeded safe limits at all gas stations (>0.601 mg/m3), with an average TVOC level of 7.53 mg/m3. Most participants showed above-normal expiratory CO levels (53.6%). The average of the PM2.5 level was moderate. Conclusion: This study found no significant correlation between exhaled CO levels and decreased lung function among petrol station attendants, likely due to their shorter duration of work and age under 40 years.
Dry Pleuroscopy as a Diagnostic Tool for Lung Cancer with Minimal Pleural Effusion Putra, Muhammad Ryan Adi; Aniwidyaningsih, Wahju; Martini, Ni Putu Laksmi Ananda
Respiratory Science Vol. 6 No. 1 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i1.178

Abstract

Dry pleuroscopy is a minimally invasive procedure used to evaluate and manage pleural conditions, particularly in cases of minimal pleural effusion (mini-PE) or dry pleural dissemination (DPD). This procedure involves the induction of artificial pneumothorax to create a workspace, allowing for direct access to the pleura without relying on a significant pleural effusion, unlike wet pleuroscopy. The key advantages of dry pleuroscopy include the elimination of the need for general anesthesia, mechanical ventilation, or specialized operating rooms, thereby reducing the risk of complications and associated costs. With a sensitivity of 94.4% and a specificity of 92.8%, dry pleuroscopy is highly effective for diagnosing lung cancer and pleural metastases in cases of minimal effusion. It also aids in lung cancer staging, minimizing the need for invasive procedures like lobectomy in complex cases. Artificial pneumothorax is a key step in dry pleuroscopy. It can be achieved through blunt dissection, optical trocars, or specialized tools such as the Boutin needle or Veress cannula. Ultrasound (USG) guidance further enhances procedural accuracy and safety by reducing complications. Dry pleuroscopy provides a safe, effective, and cost-efficient diagnostic and therapeutic solution, making it preferable to methods such as video-assisted thoracoscopic surgery (VATS), especially in patients unfit for invasive procedures.
Factors Associated with Delayed 2-Month Sputum Smear Conversion in MDR-TB Patients Treated with All-Oral Regimen at Persahabatan Hospital Sitinjak, Sahat Anugerah Immanuel; Harfiani, Erna; Tjang, Yanto Sandy; Muktamiroh, Hikmah; Sutarto, Riyadi
Respiratory Science Vol. 6 No. 1 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i1.183

Abstract

Background: The emergence of multidrug-resistant tuberculosis (MDR-TB) presents significant challenges in achieving treatment success. Sputum conversion time, an essential indicator of treatment progress, varies among patients and may be influenced by demographic and clinical factors. This study aimed to identify factors associated with sputum conversion time in MDR-TB patients treated with all-oral regimens at Persahabatan Hospital during the 2021–2022 period. Method: This retrospective cohort study analyzed data from 154 MDR-TB patients treated with all-oral regimens at Persahabatan Hospital. Patients were categorized by sputum conversion time (≤2 months or >2 months). Independent variables included age, sex, diabetes mellitus, anemia, previous TB treatment, pulmonary cavitation, education level, marital status, and initial sputum AFB results. Inclusion criteria were primary pulmonary MDR-TB patients confirmed via sputum culture, aged ≥20 years, and treated per Indonesian national guidelines. Logistic regression analyses identified significant factors. Results: Among the nine factors studied, four significantly influenced sputum conversion time: elderly age, anemia, pulmonary cavitation, and initial sputum AFB results. Older age (≥60 years) was protective against delayed conversion, while anemia, pulmonary cavitation, and higher initial sputum AFB results were associated with prolonged conversion times. Conclusion: Factors such as anemia, pulmonary cavitation, and initial sputum results are associated with delayed sputum conversion, with elderly age as a protective factor against delayed sputum conversion.
Navigating Airway Dilemmas in Massive Lung Abscess: A Case Report of Risking Rupture to Save Ventilation Putri, Nurul Hazi; Fauzi, Zarfiardy Aska; Ananda, Pratama
Respiratory Science Vol. 6 No. 1 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i1.185

Abstract

Background: Lung abscess is a necrotizing infection with cavitary lesions and air fluid levels, most often from aspiration, hematogenous spread, or bronchial obstruction. Despite better antibiotics, large abscesses remain difficult to manage, especially with respiratory failure and altered consciousness. Case: A 49-year-old woman with uncontrolled hypertension who presented with progressive shortness of breath, cough, and fever. On admission to the Respiratory Intensive Care Unit (RICU), the patient appeared acutely ill, with a Glasgow Coma Scale of E4M6V4 and signs of systemic inflammation, hypoalbuminemia, and elevated D-dimer. Chest imaging revealed a large cavitary lesion in the left lower lobe (9.4 × 12.5 × 12.4 cm) with segmental atelectasis. PaO₂/FiO₂ ratio was 210, indicating mild oxygenation impairment. Blood cultures yielded Staphylococcus haemolyticus. Due to declining consciousness and respiratory effort, the patient underwent endotracheal intubation with lung-protective ventilation. A chest tube was placed, draining 300 mL of purulent fluid. The patient improved clinically and radiographically and was discharged, with successful extubation and recovery over ten days. Discussion: This case shows that managing a massive lung abscess in a critically ill patient demands individualized, multidisciplinary decisions that balance airway protection, infection control, and procedural safety, using head-up RSI with minimal-pressure ventilation and early cuff inflation, strict lung-protective settings, and timely chest-tube drainage. Stabilization was achieved despite a negative sputum culture and Staphylococcus haemolyticus bacteremia, in the context of complicating comorbidities. Conclusion: Timely intubation and individualized drainage strategies using a multidisciplinary approach are essential in managing large pulmonary abscesses in critically ill patients.
Hematologic and Non-Hematologic Side Effects in Lung Cancer Patients Post Chemotherapy at Arifin Achmad General Hospital Oinike, Irene; Munir, Sri Melati
Respiratory Science Vol. 6 No. 1 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i1.186

Abstract

Background: Lung cancer is the second-highest cause of malignancy in the world, with a prevalence of 11.4% of all types of cancer. The majority of lung cancer patients are diagnosed at an advanced stage; therefore, chemotherapy acts as palliative therapy without curative therapy options. Chemotherapy drugs have various side effects, both hematologic and non-hematologic. Thus, monitoring side effects should be notable to improve the quality of life for patients with lung cancer undergoing chemotherapy. Method: This research was a descriptive study with a total sampling data collection technique. Samples were collected for 6 months according to the inclusion criteria, and the results were presented in the form of a distribution table. Results: During August 2023 to January 2024, 29 lung cancer patients met the inclusion criteria at Arifin Achmad General Hospital. Of these 29 patients, 25 (86.21%) were men and 4 (13.79%) were women. The hematologic side effects were observed in 16 (55.17%) patients, while non-hematologic side effects were found in 18 (62.07%) patients. The most common hematologic side effect is anemia, and the most common non-hematologic side effect is gastrointestinal disorders. Conclusion: The chemotherapy regimen used for lung cancer patients caused both hematologic and non-hematologic side effects. The non-hematologic side effects were more common than the hematologic.

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