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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 10 Documents
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Search results for , issue "Vol 41, No 4 (2021)" : 10 Documents clear
The Role of Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and D-Dimer in Predicting the Outcome of Confirmed COVID-19 patients Fathiyah Isbaniah; Tomu Juliani; Triya Damayanti; Dewi Yenita; Faisal Yunus; Budhi Antariksa; Wahyu Aniwidyaningsih; Sita Laksmi Andarini; Diah Handayani
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.215

Abstract

Background: Cytokine storm or hyperinflammation condition in COVID-19 patients could result in fatal outcomes. Inflammation could also result in coagulation disorders. The Neutrophil-Lymphocyte Ratio (NLR) and Platelet-lymphocyte ratio (PLR) have been known as inflammation markers in several diseases. D-dimer value can be used to assess a patient's coagulation status. Further study on thromboinflammation biomarkers in COVID-19 patients is needed. Therefore, we conducted a study to assess the association between NLR, PLR, and d-dimer on the clinical outcome of confirmed COVID-19 patients at Persahabatan Central Hospital.Methods: Observational cohort retrospective analysis was conducted on 214 medical records of confirmed COVID-19 patients who meet the inclusion criteria in Persahabatan Central Hospital from March to July 2020.Results: The mean patient’s age in this study is 54.35 years, dominated by male patients (60.7%). Most of the patients had normal nutritional status (54.7%). The proportion of patients with comorbidities is 65.4%. The most common comorbid is hypertension, followed by diabetes mellitus. 76.1% of patients have severe-critically ill disease, followed by moderate (20.1%) and mild disease (3.7%) The length of hospitalization median were 12 days. Sixty patients (28%) have died during hospitalization. The median of initial value of NLR, PLR, and d-dimer is 5.75 (0.68–81.5), 243.5 (44.7–1607), and 1140 (190–141300) respectively. We found significant associations between NLR (p = 0.000), PLR (p=0.013) and d-dimer (p = 0.032) on clinical outcome. Conclusion: Initial value of NLR, PLR, and D-dimer of confirmed COVID-19 patients at Persahabatan Central Hospital were associated with clinical outcome. 
Gender Disparities in Their Effects on Characteristics and Prognostics of Lung Cancer Patients in Pulmonary Ward of Dr. M Djamil Hospital, Padang Sabrina Ermayanti; Afriani Afriani; Sari Nikmawati; Russilawati Russilawati; Irvan Medison; Suyastri Suyastri
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.216

Abstract

Background: Lung cancer incidence in female tends to increase in many countries. Various studies have reported the characteristics of lung cancer in female are different from male. The purpose of this study was to determine the effect of gender on characteristics of lung cancer at Dr. M Djamil Hospital, Padang.Methods: A retrospective analytic study of lung cancer patients treated in the Pulmonary Ward of Dr. M. Djamil Hospital Padang from January 1, 2004 to December 31, 2017, with recognized cancer cell types. Data were grouped according to gender.Results: This study found that 451 lung cancer patients, male-dominant 77.8%. Female were younger than male (52.97 ± 12.79 years vs. 57.81 ± 11.23 years; p = 0.00). Most of male (94.5%) were smokers and former smokers, while 93.9% of female were non-smokers (p = 0.00). Most female were having prior history of tuberculosis (TB) (21.2% vs 11.0%; p = 0.008) and also prior history of other organs cancer (10.1% vs 3.4%; p = 0.007) than in male. Squamous cells were highest in males (41.1%), while females had adenocarcinoma (55.0%); with p = 0.008. Advanced stage in female more than male (91.8% vs 82.7%; p = 0.027). The mean life expectancy of female was longer than male, respectively 8.74 ± 1.56 and 7.29 ± 0.64 months; (p = 0.95).  Conclusion: There are differences in the epidemiology of lung cancer between male and female in Dr. M. Djamil Hospital Padang in the form of age, cell type and staging. Non-smokers, a previous history of TB and a history of cancer in other organs were more dominant in female.
Role of Interventional Radiology in the Management of Massive Hemoptysis Prijo Sidipratomo; Gabriela Enneria Sibarani
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.220

Abstract

Massive hemoptysis is one of the emergencies in respiratory system, representing hemorrhage of the bronchial or pulmonary vascular system into the respiratory tract. Massive hemoptysis is a life-threatening condition due to high risk of asphyxia it may induce. Bronchial artery embolization (BAE) is an interventional radiology procedure dedicated in the emergency management of massive hemoptysis. BAE is known for its great success rate and low risk of complications. Proper catheterization technique, recognition of bronchial artery variant anatomy and appropriate selection of embolic material agent proves essential in determining the success of this procedure. As a minimally invasive procedure, BAE is highly recommended to be used in cases of massive hemoptysis.
Immunological Aspects of Latent Tuberculosis Infection in Diabetes Mellitus Yunita Arliny
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.219

Abstract

AbstractThe interaction of diabetes mellitus (DM) with tuberculosis (TB) is currently a health concern. Diabetes mellitus is one of the main risk factors for TB infection to become latent TB and / or progress to active TB. Immune mechanisms contribute to this increased risk. The disruption of the mycobacteria recognition process, phagocyte activity and cellular activity will affect the disruption of cytokine and chemokine production. Hyperglycemia that occurs will result in delayed adaptive immune response resulting in reduced Th1, Th2, and Th17 cells as well as the cytokines produced by these cells that play a role in macrophage activation and TB inflammatory response. Understanding of the immune mechanisms that underlie the sensitivity of DM to TB infection, especially latent TB, will facilitate the implementation of strategies in screening and therapy to deal with the double burden of both diseases. The purpose of this literature study focuses on the relationship of DM with latent TB infection in terms of immunology.
Neutrophil To Lymphocyte Ratio as A Marker of COVID-19 Disease Severity in Banda Aceh Devi Efrina; Herry Priyanto; Novita Andayani; Yunita Arliny; Budi Yanti
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.207

Abstract

Background: Patients with severe COVID-19 always coincide with high mortality rate, meanwhile, inflammatory immunity parameters in COVID-19 infection such as Neutrophil to Lymphocyte Ratio (NLR) reflect the infection progress. These are used by clinicians for early identification of patients at high risk or to determine when it is a serious disease. This study aims to determine the effectiveness of NLR as a marker of COVID-19 pneumonia severity.Method: This study was conducted using a retrospective cross-sectional analytical design at the Regional General Hospital of DR. Zainoel Abidin Banda Aceh from June to September 2020. Patients' demographic characteristics, comorbidities, clinical manifestations of COVID-19 infection, chest x rays, examination of blood samples at admissions such as leukocytes, lymphocytes, neutrophils and NLR were extracted from medical record data. The patients were divided into four groups according to the disease severity, namely mild, moderate, severe and critical.Result: A total of 105 medical records were collected for COVID19 patients, meanwhile, 51 to 70 years was the largest age group (60.8%) with twice male than female. Moreover, fever, cough, shortness of breath and weakness are the most common symptoms found in treated patients while almost two-thirds of the patients have bilateral pneumonia. Generally, the levels of leukocytes, neutrophils, NLR were found to increase while the levels of lymphocytes decreased, in addition, more than half of the COVID19 patients were severe. There was a strong relationship between an increase in NLR levels and COVID-19 disease severity (95% CI, α: 0.05, p = 0.001)Conclusion: Based on the results, NLR is applicable as an early inflammatory marker which reflects severe and critical COVID19 infection and also suitable as an objective basis for early identification and management of severe COVID-19 pneumonia.
Lung Function Impairment Among Firefighter After Forest Fire Disaster in Riau, Sumatra Rudi Kurniawan; Seira Putri Boru Rambe; Indra Yovie; Erlang Samoedro; Agus Dwi Susanto; Jamal Zaini
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.210

Abstract

Background: The 2015 forest fire disaster affected almost 2.6 million hectares of land in Indonesia, and Riau was among the worst. Firefighters were the first responders to deal with the disaster, but a little was known about the influence of extinguishing forest fire activities with their health. This study aimed to evaluate respiratory symptoms and lung function among firefighters 6 months after forest fire exposure.Methods: Interviews were conducted regarding sociodemographic factors, respiratory symptoms, and history of forest fire exposure during the disaster. Spirometry and chest X-ray were also carried out with standard techniques. Statistical analysis was performed based on the existing data. Ninety firefighters participated in this study, most were male with mean age of 33 years old. About 66% were smoker, had been working as firefighters for 2 to 10 years, and had been on extinguishing forest fire duty around 2–5 hours/day during the disaster.Results: All firefighters reported respiratory symptoms after 3 months. Pulmonary function was abnormal in 50% of subjects with mild restrictive characteristic. The analysis showed that body mass index (BMI) and duration of exposure had a significant correlation with pulmonary function abnormality.Conclusion: Pulmonary function was found abnormal in most subjects 6 months after forest fire exposure in Riau.
Correlation between Measurement of Lung Diffusion Capacity Using Single Breath Methods (DLCO-SB) and COPD Group in Persahabatan Hospital Jakarta Efriadi Ismail; Faisal Yunus; Triya Damayanti
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.218

Abstract

Background: This was a preliminary study to measure DLCO-SB on COPD patients in Persahabatan Hospital to understand the prevalence of DLCO reduction among COPD patients.Methods: This was a cross sectional study of COPD patients who attended COPD-Asthma clinic in Persahabatan Hospital Jakarta. Spirometry and DLCO-SB were performed consecutively during May–July 2015.  Comorbidities were also recorded.Results: Spirometry and DLCO-SB measurements were conducted on 65 COPD subjects of which 10.8% subjects were in COPD Group A, 29.2% Group B, 32.3% Group C and 27.7% Group D. The mean age was 64.15; mean FEV1% was 46.05%, mean DLCO measured was 19.42 ml/min/mmHg and the mean DLCO% was 72.00%. The proportion of DLCO decline among COPD patients was 56.92%.  There were significant correlations between COPD group, GOLD COPD grade, FEV1, BMI and comorbidities with the DLCO value results. There were no significant correlation between DLCO value with sex, age, smoking history, Brinkmann Index, obstructive-restrictive criteria, comorbidities and length of COPD period. Conclusion: The proportion of DLCO decline among COPD patients was 56.92%. There were significant correlations between COPD group, GOLD COPD grade, FEV1, BMI and previous TB history with the results of DLCO.
Specific levels of calcidiol, calcitriol, cathelicidin and interferon gamma in diabetic patients with TB infection in Jakarta, Indonesia; Case control study Yunita Arliny; Dewi Behtri Yanifitri; Budi Yanti; Diennisa Mursalin
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.221

Abstract

Vitamin D plays a role in regulating the immune system via Vitamin D receptors, expressed by T-helper cells (Th). Cathelicidin LL-37 is an antimicrobial peptide that acts as the primary barrier against the Mycobacterium tuberculosis bacterial infection, which is induced by calcitriol, the active form of Vitamin D3. Interferon gamma (IFN-γ) is a cytokine released by Th-1 cells, and is essential for the elimination of M. tuberculosis. This study aims to determine the state of, and correlation between, calcidiol, calcitriol, cathelicidin and IFN-γ levels, as well as other clinical factors among patients with Type 2 Diabetes Mellitus (T2DM) with active TB coinfection. Further analysis is also performed to study the differences between T2DM patients with active tuberculosis, latent TB and without TB infection.
The Differences in Urokinase Plasminogen Activator System in Lung Cancer Patients Before and After Chemotherapy Tri Wahju Astuti; Agustin Iskandar; Mufidatun Hasanah; Lindayanti Sumali; Dian Nugrahenny
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.214

Abstract

Background: Lung cancer is still the leading cause of death for malignancies worldwide. Urokinase plasminogen activator (uPA), its soluble receptor (suPAR), and its inhibitor (PAI-1) play an important role in tumor invasion and metastasis. This study aimed to evaluate the differences in the urokinase plasminogen activator system (uPA, suPAR, and PAI-1) in lung cancer patients before and after chemotherapy.Methods: This research was an observational analytical study with a cross-sectional design. The subjects were 30, consisting of 17 lung cancer patients before chemotherapy and 13 lung cancer patients after chemotherapy for 4 or 6 cycles. The levels of serum uPA, suPAR, and PAI-1 were measured by enzyme-linked immunosorbent assay (ELISA). Results: In lung cancer patients before chemotherapy, there were no significant (p>0.05) differences in levels of serum uPA, suPAR, and PAI-1 between patients with stage III and IV. The highest serum uPA and suPAR levels were found in adenocarcinoma cell types and the highest serum PAI-1 level in adenoepidermoid cell types. After chemotherapy, serum suPAR and PAI-1 were significantly (p < 0.05) decreased in lung cancer patients. However, there were no significant (p>0.05) differences in the levels of serum uPA, suPAR, and PAI-1 between patients with chemotherapy responses for stable and progressive diseases. Conclusion: This study revealed that suPAR and PAI-1 levels were decreased in lung cancer patients who had received chemotherapy. This can occur due to decreased tumor cells activity. 
Inflammatory Markers upon Admission as Predictors of Outcome in COVID-19 Patients Budhi Antariksa; Erlina Burhan; Agus Dwi Susanto; Mohamad Fahmi Alatas; Feni Fitriani Taufik; Dewi Yennita Sari; Dicky Soehardiman; Andika Chandra Putra; Erlang Samoedro; Ibrahim Nur Insan Putra Darmawan; Hera Afidjati; Muhammad Alkaff; Rita Rogayah
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.185

Abstract

Background: Coronavirus disease 2019 (COVID-19) may cause dysregulation of the immune system, leading to hyperinflammation. Inflammatory markers can be used to predict in-hospital mortality in COVID-19 patients. This research was aimed to investigate the association between the levels of various inflammatory markers and mortality in COVID-19 patients.Methods: This study was conducted at Persahabatan National Respiratory Referral Hospital, Indonesia. Blood tests were performed upon admission, measuring the C-reactive protein, PCT, leukocyte, differential counts, and platelet count. The outcome measured was the mortality of hospitalized COVID-19 patients. Statistical analysis methods included the Mann–Whitney U test, receiver operating characteristic (ROC) analysis, and area under the curve (AUC) test.Results: Total 110 patients were included, and the laboratory values were analyzed to compare survivors and non-survivors. The non-survivor group had significantly higher leukocyte count, lower lymphocyte count, higher CRP and PCT levels, higher neutrophil-to-lymphocyte ratio (NLR), higher platelet-to-lymphocyte ratio (PLR), and lower lymphocyte-to-CRP ratio. As predictors of mortality, AUC analysis revealed that PCT, CRP, NLR, and PLR had AUCs of 0.867, 0.82, 0.791, and 0.746, respectively.Conclusions: Routine and affordable inflammatory markers tested on admission may be useful as predictors of in-hospital mortality in COVID-19 patients requiring hospitalization.

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