Sigit, Indarto
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LEVEL OF CONFORMITY EXAMINATION OF URIC ACID LEVELS IN PLEURAL FLUID, RATIO OF URIC ACID LEVELS IN PLEURAL FLUID WITH SERUM TO DISTINGUISH EXUDATES AND TRANSUDATES Sigit, Indarto; Sutanto, Yusup Subagio; Harsini, Harsini
Jurnal Respirologi Indonesia Vol 40, No 2 (2020)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v40i2.100

Abstract

Background: Uric acid can be used as a biomarker to distinguish transudates from pleural fluid exudates. Uric acid is soluble in liquid media, elevated levels of uric acid in blood plasma become a predisposing factor for uric crystal deposits in tissues and body fluids. Increased permeability due to changes in capillary pleural pressure in the formation of transudates is a cause of increased levels of uric acid in pleural fluid. The aim of the study was to analyze the examination of pleural fluid uric acid levels and the ratio of uric acid levels to pleural fluid to serum to distinguish exudates and transudates in pleural effusion. Methods: A cross sectional diagnostic test with a cross sectional study design in pleural effusion patients at RSUD Dr. Moewardi Surakarta in July-August 2019. Subjects were examined for pleural fluid levels, serum uric acid ratio, and pleural fluid analysis. Results: A total of 30 pleural effusion patients were included in this study. The level of agreement between the uric acid pleural fluid against Light criteria was in the moderate category and statistically significant (Kappa = 0.595; P=0.001). The level of agreement between the ratio of uric acid to pleural fluid and serum to Light's criteria was weak and not statistically significant (Kappa = 0.200; p = 0.195) Conclusion: The level of concordance between pleural fluid uric acid with Light criteria is in the medium category and statistically significant. There is no match between the ratio of serum pleural fluid uric acid levels with Light criteria. (J Respir Indo. 2020; 40(2): 82-6)
The Relationship of Amount of Pleural Fluid and Time of Pleurodesis with the Results of Pleurodesis in Malignant Pleural Effusions Sutanto, Yusup Subagio; Sigit, Indarto; Kurniawan, Hendra
Indonesian Journal of Medicine Vol 5, No 4 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Pleural effusion can be an early sign of lung cancer in more than 25% of cases. Lung cancer is the most common cause of ma­lignant pleural effusion (MPE). Pleuro­desis is performed when the amount of pleu­ral fluid is <150 ml/day, but it is difficult as its productive nature. This study aimed to find the right time to perform pleurodesis on patients with MPE, which is expected to achieve optimal results.Subjects and Method: This was a cross-sec­tio­nal study conducted at Dr. Moewardi Hos­pital, Surakarta, Central Java, from June to July 2020. The study subjects were 17 pati­ents with malignant pleural effusion (MPE) diag­nos­ed with lung cancer who underwent water seal drainage (WSD) and indicated for pleurodesis. The dependent variable was the success of the pleurodesis procedure. The independent varia­bles were the amount of evacuated pleural fluid and the time of pleu­rodesis performed. The stu­dy instruments were diagnosis of lung cancer with anatomic pathology, measurement of the amount of pleural fluid, and posteroanterior chest X-ray evaluating the success of pleuro­desis. The data were analyzed using Spearman corre­lation, ANOVA to determine the differen­ces in the amount of pleural fluid at the first, second, and third hours, and continued with post hoc LSD analysis using SPSS 21.Results: The pleurodesis success rate had posi­tive correlation with the amount of pleural fluid (r= 0.24; p= 0.345) and the time of pleu­ro­­desis performed at the first hour (r= 0.10; p= 0.701), second hour (r= 0.03; p= 0.921), and third hour (r= 0.41; p= 0.106). Pleurodesis per­form­ed at the second hour had the lowest amount of pleural fluid (Mean= 84.66; SD= 38.88), followed by third hour (Mean= 110.77; SD= 65.57), and first hour (Mean= 111.22; SD= 57.83), but the differences were not statistically significant (p= 0.285).Conclusion: The pleurodesis success rate has a positive correlation with the amount of pleu­ral fluid and the time of pleurodesis, but it was not statistically significant. There is no signifi­cant difference in the amount of pleural fluid eva­cuated at the three different times of pleuro­desis. The least amount of pleural fluid obtains at the second hour (14.00-22.00).Keywords: malignant pleural effusion, amou­nt of pleural fluid, pleurodesis, pleuro­desis timeCorrespondence: Yusup Subagio Sutanto. Department of Pul­mo­­­no­logy and Respiratory Medicine, Fa­culty of Me­di­cine Universitas Sebelas Maret, Dr. Moewar­di Hospital, Surakarta. Jl. Kolonel Sutarto 132, Surakarta 57126, Central Java. Email: dr_­yusupsubagio­@yahoo.com. Mobile: +628112­8­­4165.Indonesian Journal of Medicine (2020), 05(04): 337-342https://doi.org/10.26911/theijmed.2020.05.04.09.