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INDONESIA
Jurnal Respirologi Indonesia
Published by Perhimpunan Dokter Paru Indonesia
ISSN : 08537704     EISSN : 26203162     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Jurnal Respirologi Indonesia (JRI) is an online and printed scientific publication of the Indonesian Society of Respirology (ISR). The journal is published thrice-monthly within a year (January, April, July and October). The journal is focused to present original article, article review, and case report in pulmonary and critical care medicine.
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Articles 12 Documents
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Search results for , issue "Vol 42, No 2 (2022)" : 12 Documents clear
Increased Serum SP-D Level, Neutrophils and Lymphocytes Sputum in Malang Splendid Bird Market Workers Ratih Dwi Ary Merdekawati; Tri Wahju Astuti; Garinda Alma Duta
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.304

Abstract

Background: Workers in the bird market have a high risk of exposure in the form of air pollution, pollutant particles including debris / organic dust, loose feathers, insects/ticks, aerosol particles in food, bird excreta (ammonia), various kinds of gram bacteria, fungi and virus. Exposure to particles will stimulate the immune system against harmful pathogens in the form of inflammatory response. An infection or injury will stimulate the secretion of Surfactant protein-D (SP-D) which is a group of collectin (collagen-lectin) with subgroups of the C-type lectin superfamily, together with bovine coglutinin, mannose-binding lectin (MBL), and CL43 protein. This aim of this study was to determine serum SP-D and neutrophil and sputum lymphocyte levels in workers at splendid bird market.Methods: A cross sectional analytic observational study on 35 subjects, analyzed the characteristics of the workers, calculated neutrophil types, lymphocytes on induced sputum and serum SP-D levels using sandwich ELISA.Results: Mean SP-D serum levels in workers in the bird market environment increased (mean SD: 81.39 + 47.656 ng/ml) from normal levels (60 ± 3 ng/ml). There was a significant positive correlation between length of exposure and serum SP-D levels (r: 0.693; p <0.001). There was an average increase in the percentage of neutrophils and sputum lymphocytes (90.71% + 4.04% and 9.17% + 4.42%) compared to normal limit (50.3% + 23.5% and 2.6% + 5.2%).Conclusion: Inhalation exposure in the Bird Market environment can cause an increase in the percentage of neutrophils, sputum lymphocytes and serum SP-D levels in workers that indicate an airway inflammation process, as well as an alleged increase in alveolar wall permeability, damage and regeneration of alveolar epithelial cell type II cells (AEC type II).
Impact of Underweight on the Unsuccessful Treatment Outcome among Adults with Drug-Resistant Tuberculosis: A Systematic Review Kemas Rakhmat Notariza; Jaka Pradipta
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v41i4.228

Abstract

Background: The emergence of drug-resistant (DR) strains of Mycobacterium tuberculosis has disrupted the control of tuberculosis (TB) problem worldwide. Most of DR-TB patients presents with underweight problems. Prior studies showed that body mass index affects sputum conversion and could be a predictor of treatment outcome, but the causal relationship has not been established yet. This systematic review aimed to determine the impact of underweight on the unsuccessful treatment outcome among adults with DR-TB.Methods: Systematic literature search and handsearching were done in four databases: Cochrane, Proquest, Pubmed, and ScienceDirect. Filtering process by using selection criteria yielded 4 eligible articles (2 prospective cohort and 2 retrospective cohort studies) for answering the clinical question. Critical appraisal was conducted by using the Newcastle-Ottawa Quality Assessment Scale (NOS).Results: All four studies were assessed as having high quality according to the NOS score. The findings of all eligible studies were consistent in revealing the impact of underweight on the unsuccessful treatment outcome in DR-TB, with the relative risk: 2.194 (95% confidence interval [CI], 1.134–4.246), 1.771 (95% CI, 1.069–2.931), 3.465 (95% CI, 1.114–2.712), and 4.703 (95% CI, 1.709–12.947), consecutively. The number needed to harm (NNH) of 3–7 indicated the clinically meaningful harm of the exposure. This systematic review showed that one poor outcome incidence could be found with only a few underweight DR-TB patients.Conclusion: Underweight increased the risk of unsuccessful treatment outcome among adults with DR-TB. Low baseline body weight (<40 kg) could be another considerable factor in anticipating the poor treatment outcome. 
Differences in Levels of Human 1,3β-D-Glucan from Bronchoalveolar Lavage (BAL) Fluid in The Immunocompromised and Immunocompetent Groups Patients with Suspected Lung Cancer Asih Trimurtini; Ngakan Putu Parsama Putra; Teguh Rahayu Sartono; Harun Al Rasyid
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.298

Abstract

Background: Invasive candidiasis occurs in immunocompromised individuals as an opportunistic infection in patients with lung cancer. Although culture and histopathology remain the standard diagnosis of fungal infections, other tests are still needed to provide faster results. Human 1,3-β-D-Glucan (BDG) uses ELISA to detect candidiasis. β D-Glucan level from BAL fluid is positive when the cut-off is p 130 pg / mL. This study aims to determine differences in the levels of Human 1,3β-D-Glucan from Bronchoalveolar Lavage (BAL) fluid between the immunocompromised and immunocompetent groups in patients with suspected lung cancer at RSU Dr. Saiful Anwar Malang.Method: A cross-sectional study was conducted on 33 lung cancer patients who had risk factors for invasive candidiasis in Dr. Saiful Anwar Hospital Malang.Result: 33 study patients had significant differences in BAL levels of Human 1,3β-D-Glucan in the immunocompromised and immunocompetent groups (p = 0.009). In the different tests, there was a slight difference in the levels of BAL Human 1,3β-D-Glucan but it was not statistically significant based on age and sex in the immunocompromised and immunocompetent groups (p = 0.632, p = 0.338, p = 0.472, p = 0.667).Conclusion: Patients suspected of lung cancer have risk factors for invasive candidiasis with higher BDG levels due to immunoparalysis. There were significant differences in the BAL Human levels of 1,3β-D-Glucan in the immunocompromised and immunocompetent groups.
Immune Checkpoint Marker of Programmed Death Ligand-1 (PD-L1) Expression in Surgical Lung Cancer Specimens Elisna Syahruddin; Jamal Zaini; Lisnawati Lisnawati; Yayi DB Susanto; Sarah Fitriani; Shanty R. Kusumawardani; Romi Baginta
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.286

Abstract

Background: Currently immune checkpoint pathways of PD1-PD-L1 is being used to treat lung cancer and PD-L1 served as predictive biomarker. Investigations of PD-L1 expression as a target immunotherapy in lung cancer specimens in Indonesia is needed. This study aimed to evaluate PD-L1 expression in resected lung cancer specimens using immunohistochemistry techniques. Methods: Thirty surgically resected sample from lung cancer patients were obtained. The whole specimens were stained by using immunohistochemistry techniques automatically in BOND-MAX Autostainner (Leica, Germany). PD-L1 polyclonal antibody (Genetex) at 1:1500 dilution was applied to immunohistochemistry staining procedure. Clinicopathological characteristic were acquired from the hospital registry database.Result: A total of 30 surgical specimens were assessed from lung cancer patients. Twenty-four (80%) of them were Adenocarcinoma (AC), 1 (3, 33%) Adenosquamous carcinoma, 2 (6, 67%) were Squamous Cell Carcinoma (SSC), 1 (3, 33%) were Large Cell Carcinoma, 1 (3, 33%) were Neuroendocrine Carcinoma, 1 (3, 33%) were Adenoid Cyctic Carcinoma. The expression of PDL-1 positive reactivity was 16 of 30 (53.3%) specimens and we categorized into strong positivity (>50%), medium (= 50%) and low positivity (<50) from 21 specimens, 0 specimens and 7 specimens respectively.Conclusion: PD-L1 expression could be detected in lung cancer specimen using polyclonal antibody.
Risk Factors for Mortality of Patients with Covid-19 in RSJPD Harapan Kita, Jakarta Zhara Juliane; Asri Chasanah Adisasmita; Yoga Yunadi
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.287

Abstract

Abstract Background:TheCovid-19 disease has caused significant morbidity and mortality worldwide since Covid-19 was first reported in December 2019. More intense kinds of the disorder main to loss of life arise greater regularly in older sufferers and people with more than one comorbidities. This study  aims  to determine the risk factors associated with death in Covid-19 patients at RSJPD Harapan Kita.Methods:A total of 500 patients with a positive result on the Covid-19 polymerase-chain-reaction (PCR) test from RSJPD Harapan Kita were analyzed. The Demographic, clinical, and outcome data were extracted from the hospital's medical record system.  To explore the risk factors associated with mortality, univariable and multivariable logistic regression analyses were used.Results:Of the 500 patients included in this study, 110 (22%) died in the hospital. The multivariate regression analysis showed that age³65 years (adjusted odds ratio (aOR), 2,624; (95% CI: 1,552 – 4,435), chronic lung disease (aOR, 8,173; 95% CI: 3,834 – 17,422), chronic kidney disease (aOR,2,523; 95% CI: 1,358 – 4,689), and cardiovascular disease (aOR, 3,149; 95% CI: 1,763 – 5,624) had been recognized as risk factors of mortality among Covid-19 patients. Conclusion: Age ³65 years, chronic lung disease, chronic kidney disease patients, and cardiovascular disease had been recognized as risk factors of mortality among Covid-19 patients in RSJPD Harapan Kita. More research on the risk factors related to Covid-19-associate death is had to manage ailment development and to enhance its treatment.Keywords: Covid-19, Risk Factors, Mortality, Comorbidities.
The Relationship of Genetic Polymorphism Micromal Epoxide Hydrolase (EPHX1) His139Arg and Lung Cancer Rosidah Hanum Hasibuan; Noni Novisari Soeroso; Setia Putra Tarigan; Yahwardiah Siregar; Erna Mutiara; Lucia Aktalina
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.305

Abstract

Background: Microsomal epoxide hydrolase 1 (EPHX1) plays an important role in both activation and detoxification of polycyclic aromatic hydrocarbons (PAH) and aromatic amines. Polymorphism EPHX1 His139Arg in susceptibility to lung cancer has been reported with inconsistent outcomes. Aim of this study was to analyze the relationship between this polymorphism and lung cancer in smokers.Method: Consecutive sampling and case-control study was applied. Genotyping was performed by PCR-RFLP assay. The chi-square test with p<0.05 considered as significant.Results: Of all 84 subjects, in case and control groups, wild-type variant His139His were 34 (81%) and 30 (71.4%), heterozygote variant His139Arg were 8 (19%) and 12 (28.6%), there was no homozygote variant Arg139Arg identified. (p=0.36).Conclusion: The EPHX1 His139His represents a common polymorphism in both of subject groups. There is no association between His139Arg polymorphism of EPHX1 and lung cancer.
Correlation Between CEA Serum Level on NSCLC Patients with EGFR Mutation from Tissue and Plasma Sample Frenky Hardiyanto Hendro Sampurno; Suryanti Dwi Pratiwi; Ngakan Putu Parsama Putra
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.299

Abstract

Background: Patients with NSCLC can have EGFR mutation and increased level of CEA. EGFR mutation test on NSCLC has very important role for EGFR tyrosine kinase inhibitor (TKI) therapy.CEA is also expected to predict treatment efficiency of EGFR-TKI therapy. Tumor tissue biopsy is an invasive method and has come constraints, despite the golden standard testing. Circulating tumor DNA (ctDNA) is a new and less invasive for detecting EGFR mutation using plasma sample. In this study, we investigated the relationship between serum CEA and EGFR mutations in tissue and plasma in NSCLC patient.Methods: This cross-sectional observational research was conducted in Dr. Saiful Anwar General Hospital Malang from August 2018 until July 2019, 76 NSCLC patients who had undergone test of EGFR mutation from tissue, ctDNA, and serum CEA level. Extracted DNA from plasma and tissue samples from citology or biopsy was checked for the EGFR mutation. The serum CEA levels were analyzed using electrochemical luminescence.Results: EGFR mutation from tissue samples positive detected on 34 subjects and ctDNA detected 19 subjects. Serum level of CEA >5 ng/ml was significantly associated with EGFR mutation from tissue sample (p=0.037) with an odds ratio of 2.778 (95% CI: 1.050-7.348), the area under curve for CEA was 68,8% and cut-off CEA 9.14 ng/ml. Serum level of CEA >5 ng/ml wasalso significantly associated with ctDNA (p=0.015) with an odds ratio of 4.8 (95% CI: 1.259-18.299), the area under curve for CEA was 78,1% and cut-off CEA 14.8 ng/ml.Conclusion: Serum CEA level has poor correlation with mutation of EGFR from tissue and moderate correlation with mutation of EGFR from ctDNA in NSCLC patients. Patients with increased level of CEA >5 ng/ml are 2.778 times more at risk to had EGFR mutation and 4.8 times more at risk to had ctDNA positive mutation.
An evaluation of short-acting β2-agonist prescriptions and associated clinical outcomes in asthma management in Indonesia – the SABINA Indonesia study Wiwien Heru Wiyono; Muhammad Amin; Susanthy Djajalaksana; Amira Permatasari Tarigan; Febrina Susanti; Hisham Farouk; Helyanna Helyanna
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.295

Abstract

Background: Asthma is a chronic inflammatory disease, therefore inhaled corticosteroid (ICS) should be as the cornerstone of asthma treatment. However patients tend to rely on short-acting β2-agonist (SABA) due to immediate symptom relief and underuse ICS, thereby undertreating the underlying inflammation. As part of the multi-country SABA use IN Asthma (SABINA) III study, we aimed to describe SABA prescription patterns and asthma-related clinical outcome in Indonesia.Methods: Cross-sectional study in asthma patients (> 12 years old) during August 2019 –  January 2020. Disease characteristic, prescribed asthma treatment in the 12 months before the study visit, and clinical outcomes, were recorded during a single visit and entered into an electronic case report form.Results: Of 219 patients recruited, the mean number of SABA canisters prescribed was 4 canisters per year. SABA over-prescription (≥ 3 canisters/year) seen in 37% patients, and was greater in moderate-to-severe vs mild asthma (40% vs 17.9%). 47.5% of patients had at least 1 severe exacerbation; and 7.3% of patients had ≥3 severe exacerbations, in the past 12 months. Almost half of the patients (40.2%) were prescribed oral corticosteroids (OCS). Overall, the well-, partly, and uncontrolled patients were 41.6%, 37.4%, and 21%, respectively.Conclusion: SABA over-prescription occurs in approximately one third of asthma patients, especially among moderate-to-severe patients and almost half of asthma patients experienced at least 1 severe exacerbation in the previous year. This highlights a public health concern and the need to improve asthma care by aligning with global recommendations including reducing SABA over-reliance in Indonesia
Comparison of Eutectic Mixture of Local Anesthesia Cream and Subcutaneous Lidocaine to Reduce Chest Tube Removal Pain and Willingness to Repeat Procedure Roman Diaz; Yusup Subagio Sutanto; Ahmad Farih Raharjo
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.297

Abstract

Background:. Patients with chest tube have allodynia (pain from stimuli that is normally painless) and hyperalgesia (increased sensitivity to pain). Anesthetics has not been used routinely when removing chest tubes assuming that the procedure is brief and that the pain is short-lived, even though it could be the most painful part of chest tube procedures.Objective: This study compared the effectiveness of local anesthetic EMLA cream and subcutaneous infiltration of lidocaine to reduce pain of chest tube removal, 10 minutes after, and it’s effect on the patient's willingness to repeat the procedure.Method: A quasi-experimental clinical trial conducted on 28 patients undergoing chest tube removal at dr. Moewardi from September 2020. The EMLA group (n = 14) received 2 grams of topical EMLA cream applied 2 hours before chest tube removal. The lidocaine group (n = 14) received subcutaneous infiltration of 2% lidocaine 5 minutes before chest tube removal. Pain was measured by VAS pain before, during, and 10 minutes after the chest tube was removed, followed by filling out a willingness to repeat procedure questionnaire.Results: Topical EMLA cream was comparable to 2% lidocaine infiltration for reducing pain during chest tube removal (p = 0.679) and 10 minutes thereafter (p = 0.833). EMLA cream did not increase the patient's willingness to repeat the procedure (p = 0.815)Conclusion: Topical EMLA cream able to replace the subcutaneous infiltration of 2% lidocaine as a local anesthetic for chest tube removal but does not increase the patient's willingness to repeat the procedure.
The Effect of Roflumilast on Absolute Neutrophil Count, MMP-9 Serum, % VEP1 Value, and CAT Scores in Stable COPD Patients Ratna Adhika; Suradi Suradi; Yusup Subagio Sutanto
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.265

Abstract

Background: Chronic obstructive pulmonary disease is the leading cause morbidity and mortality worldwide. Cigarette smoke and noxious agent causing oxidative stress activated nuclear factor-κB then increase inflammatory cell releases. Roflumilast have antiiinflammatory effect which can be use as addition therapy for stable COPD.Methods: The pretest and postest experimental clinical trial was carried out in 40 patients with stable COPD in the pulmonology outpatient clinics of Dr. Moewardi Surakarta and dr. Soehadi Prijonegoro Sragen hospital from 6 January to 6 March 2020. Forty subjects were grouped into treatment group (n=20) receiving standart therapy along with roflumilast 500 mg/day and placebo group (n=20) receiving standart therapy only for 28 days. Decreased inflammation measured by ANC and serum MMP-9, improvement of obstruction measured by % FEV1, and clinic improvement measured by CAT score.Results: Our finding revealed decreases of ANC and MMP-9 serum in the treatment group, although statistically insignificant (p=0,449), (p= 0,195) respectively. %VEP1 value increased insignificant in the treatment groups (p=0,189). Chronic obstructive pulmonary disease assessment test (CAT) score decreased significantly in the treatment group (p=0.000).Conclusion: Roflumilast administration reduce inflammation as it can lower not significant ANC, MMP-9 serum, higher not significant %VEP1, and improves the clinical condition of patients with stable COPD based on a decrease in CAT score.

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