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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 43, No 2 (2023)" : 10 Documents clear
Late-Onset Pneumothorax and Bullous Disease in Post-COVID-19 Pneumonia with Severe ARDS Ira Nurrasyidah; Vincentius Adrian Madargerong; Desi Rahmawaty
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.354

Abstract

Background: Patients with COVID-19 pneumonia may develop bullae that can rupture into spontaneous pneumothorax (SP) during the diagnosis and treatment, which can be a predictor of a poor prognosis. However, late-onset bullous disease and SP after recovering from COVID-19 are unusual.Case: A 48-year-old male presented with sudden shortness of breath accompanied by chest pain. Three weeks earlier, the patient had finished treatment in the COVID-19 isolation room for 20 days with a diagnosis of COVID-19 pneumonia with severe ARDS. Physical examination demonstrates tachypnea, desaturation, decreased vesicular breath sounds, and hyperresonance percussion on the right hemithorax; without rhonchi or wheezing. Chest X-ray and CT scan showed a right pneumothorax with infected subpleural giant bullae in right perihilar, right lung collapse, minimal right-to-left lung herniation and post-covid pulmonary fibrosis. Culture and sensitivity examination of the pleural fluid showed the growth of Providencia stuartile. A chest tube was placed for the management of the pneumothorax. Subsequently, according to the results of culture and antibiotic sensitivity test, the patient was treated using piperacilin/tazobactam and amikacin. The patient showed clinical and radiological improvement following 41 days of treatment and could be managed as an outpatient.Conclusion: Our patient had infected giant bullae and pneumothorax post COVID-19 pneumonia and severe ARDS. The patient did not undergo a bullectomy in consideration of the post-COVID-19 condition and was managed conservatively using adequate chest tube and antibiotics. Patient responded well to therapy, showed clinical improvement and could be discharged.
Clinical Response and Safety of Alternating Daily Dosage of Crizotinib due to Side Effects in Advanced NSCLC patient harboring ROS1-rearrangement: A Case Report Jamal Zaini; Muhamad Rizqy Fadhillah; Sita Andarini
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.201

Abstract

Background: Advanced lung cancer has the lowest overall survival than other stage and tyrosine kinase inhibitor (TKI) are promising to prolong life and prevent disease progression. ROS1 rearrangement was very rare and constitute around 1.4 % of all NSCLC. Previous preclinical and clinical trial have reported the efficacy and safety of crizotinib against advanced NSCLC with ROS1 rearrangement, but little is known about its efficacy with nonstandard dosage.Case: A female, 58 years old, with no history of cancer nor smoking, came with persistent chest pain and cough for three months. The patient was then diagnosed with advanced lung cancer by FDG-PET CT Scan. The biopsy confirmed adenocarcinoma with genotyped ROS1-rearrangement. After receive standar dose of 200 mg bid, the patient intolerated and treatment plan was adjusted with 200 mg of alternated daily dosage (one-day on-off drug administration). Fortunately, the intolerance symptoms were alleviated and showed positive response during 3-years therapy.Discussion: Pulmonary tuberculosis has been linked to pneumothorax in HIV-associated TB patients. This study is done to better our understanding of the link between the two. The patient had active pulmonary tuberculosis as well as HIV and a rare case of bilateral pneumothorax in the ER.Conclusion: This case showed that advanced NSCLC with ROS1 rearrangement has positive response to crizotinib despite using alternating daily dose, with good response during 3 years and on. 
Candida Glabrata Pneumonia in Post COVID-19 Patient: A Rare Case Report Jahja Teguh Widjaja; Evelyn Nathania
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.213

Abstract

Background: One of the issues in post COVID-19 is secondary infection and fungal infection is one of the complications that must be detected at early stage to prevent. Early detection to prevent underdiagnosed and undertreatment. Candida glabrata, one of the pathogens in fungal infection is rare and can acts as infectious agent with immunocompromised patients.Case: A 69-year-old man came to hospital with major complaints of cough and shortness of breath for five days. He was diagnosed COVID-19, After completed treatment the nasopharyngeal PCR swab show negative result for COVID-19. After being discharged, he did several chest X-ray examinations with progressively worsening cough. Chest CT-Scan revealed consolidations and cavity. Sputum culture was positive for Candida glabrata and negative for BTA. He received echinocandins as anti-fungal treatment, which inhibits enzymes that is necessary for fungi’s cell wall synthesis, shows clinical and radiological improvement.Discussion: COVID-19 affect immune system which resulting higher risk for secondary infection. The use of broad-spectrum antibiotics, immune-suppression of the host, and use of medical devices are major risk factors for Candida infections. Meanwhile C. Albicans is still the most common cause of fungal pneumonia by Candida, we should consider C. glabrata as one of its pathogens. Conclusion: COVID-19 affects many aspects in our life, even after we treat the main problem, some patients manifest symptoms later. Diagnosing fungal infection especially invasive candidiasis is quite challenging with higher mortality rate. Not only C. glabrata more uncommon than C. albicans, but also it was one of difficult to treat pathogens.
Convalescent Plasma Therapy in COVID-19 Patients with Acute Respiratory Distress Syndrome (ARDS) Dewi Arum Sawitri; Arie Zainul Fatoni
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.413

Abstract

COVID-19 is caused by SARS-CoV-1, an RNA virus of the betacoronavirus genus, making it the seventh coronavirus infecting humans. Because particular therapies are still in the research stage, no confirmed treatment for this illness has been agreed upon by the World Health Organization (WHO) or other clinical institutes. The reason is that there are many different potential remedies. Antiviral treatments like favipiravir, oseltamivir, and remdesivir have been investigated and tested. On the other hand, the outcomes of the replies of patients who were given these medications are still quite inconsistent. Furthermore, the COVID-19 mortality rate has remained at a level of less than 5.21 percent of cases that have been documented. Patients suffering from COVID-19 may be treated with convalescent plasma, a therapeutic option that utilizes a mix of neutralizing antibodies and other immunological components. Activation of body-dependent cellular cytotoxicity (ADCC) and phagocytic activity against COVID-19 will occur due to this immunological component. This medication also has the potential to reduce the systemic inflammatory response brought on by COVID-19. Clinical improvement was different after 28 days when convalescent plasma was used as a treatment for patients with severe COVID-19 symptoms and emergency conditions compared to patients treated with conventional therapy alone. However, it is not very significant.
Effectiveness of Vitamin C Administration on Outcome in COVID-19 Patients: A Systematic Review and Meta-Analysis Desie Dwi Wisudanti; Nur Lintang Nabilah Sri Kusumasari; Adelia Handoko; Cholis Abrori; Angga Mardro Raharjo
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.341

Abstract

Background: Numerous studies on the effectiveness of vitamin C against the COVID-19 infection have been widely carried out recently. However, the differences in dosage ranges and therapeutic efficacy in previous studies have prompted a systematic literature review on the effectiveness of vitamin C on outcomes in COVID-19 patients. In addition, this study aimed to determine the appropriate therapeutic dose of vitamin C for COVID-19 patients, either alone or in combination with other supplements, and to determine the side effects.Methods: Gleaned from the search on Pubmed, Science Direct, and Google Scholar databases up to April 25, 2022, fourteen studies were relevant, namely five studies using vitamin C orally and nine studies administered intravenously. We assessed multiple outcomes, including mortality, hospitalization, and symptoms. The quality and risk of bias analyses were performed using JBI critical appraisal tools.Results: The oral administration of vitamin C resulted in a significant difference in the mortality of COVID-19 patients (OR=0.66; 95% CI=0.45–0.97; P=0.04; I2=0%) and a non-significant difference in the outcome. Duration of hospitalization (OR = -0.21; 95% CI = -2.70-2.28; P=0.87; I2=94%). Regarding the cost-effectiveness and side effects manifested in digestive disorders such as nausea, diarrhea, stomach cramps, and vomiting, vitamin C with a dose of 500-1000 mg could be given orally.Conclusion: Oral administration of vitamin C showed a reduction in the mortality of asymptomatic COVID-19 patients with moderate symptoms.
Indonesian Society of Respirology (ISR) Consensus Statement on Lung Cancer Screening and Early Detection in Indonesia Sita Andarini; Elisna Syahruddin; Nathaniel Aditya; Jamal Zaini; Ferry Dwi Kurniawan; Sabrina Ermayanti; Noni Novisari Soeroso; Sri Melati Munir; Andreas Infianto; Ana Rima; Ungky Agus Setyawan; Laksmi Wulandari; Haryati Haryati; Ida Ayu Jasminarti; Arif Santoso
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.455

Abstract

Lung cancer is the leading cause of mortality for all cancer globally and in Indonesia. In Indonesia, lung cancer contributes to 12.6% of death of all cancer, making it the number one cause of cancer death, and 8.6% of all cancer incidence in 2018, behind breast, cervical, and colorectal cancer. The total cases per year are expected to almost double from 30,023 in 2018 to 54,983 cases in 2040. Smoking is among the risk factors for lung cancer, after occupational/environmental risk factors, history of lung fibrosis, and family history of cancer. There was a tendency of younger smokers in Indonesia and increased lung cancer incidence and prevalence in the younger population. The median age of lung cancer in Indonesia was younger than in any country, probably due to the younger age of smoking, early onset of carcinogens, asbestos use, and environmental. Lung cancer screening is a voluntary measure to detect lung cancer in the earliest stage, to find cancer at curable disease before symptoms appear in high-risk individuals. Lung cancer early detection is strategies to find cancer earlier after symptoms appear (cough, hemoptysis, dyspnea, chest pain). Low-dose computerized tomography of the thorax (LDCT) screening has been known to reduce lung cancer mortality compared to a chest x-ray (CXR). This Indonesian Society of Respirology consensus statement was aimed to give recommendations on lung cancer screening and early diagnosis in Indonesia.
Pulmonary Tuberculosis Coinfected with COVID-19 Compounded by Bacterial Superinfection: A Case Report and Critical Appraisal of The Evidence Regarding Its Mortality Kemal Akbar Suryoadji; Baiq Amalia Utami; Fairuzia Fiyanti Putri; Hilma Nur Faiza; Kezia Alicia Theresia Manik; Fathiyah Isbaniyah; Jamal Zaini
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.226

Abstract

Background: The WHO has declared COVID-19 as a global pandemic. However, Indonesia is also challenged by high burden of tuberculosis (TB). In this study, reported an active pulmonary TB case coinciding with COVID-19 but deceased due to bacterial infection. There is a need to further explore this new problem in developing countries to determine the prognosis of COVID-19 patients with tuberculosis infection.Methods: A comprehensive literature search was conducted by using databases such as The Cochrane Library, PubMed, Google Scholar, EBSCO-Host, and Scopus, including systematic reviews of cohort studies, cohorts, and case controls. As many as 309 studies were identified, after screening for duplicates and against the inclusion and exclusion criteria, three studies were included for critical appraisal.Results: The meta-analysis by Gao et al included two studies with an odds ratio (OR) of 1.4 [95% CI=0.1-18.93], the cohort study by Sy et al reported a relative risk (RR) of 2.17 [95% CI=1.4-3.37], and Motta et al showed that COVID-19 patients with tuberculosis had a mortality rate of 11.8% [95% CI=7.75-15.45]. Conclusion: TB has yet to be an identified as a major predictor of increased mortality in COVID-19 patients but can be considered a predictor of increased severity in COVID-19 patients. Studies with a bigger sample size and better study design are suggested to obtain new evidence.
Anatomical Pathology Differences in Lung Alveoli Damage with Exposure to Conventional and Electric Cigarettes Citra Paramita Esti Cahyaningrum; Desy Andari; Djoni Djunaedi
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.191

Abstract

In conventional cigarettes, tobacco is a major risk factor in the development of diseases involving the lungs, including pulmonary emphysema, fibrosis and lung cancer. Many people think that using e-cigarettes is much safer than conventional cigarettes. Whereas smoking with electronic cigarettes can cause the same feeling of cotton mouth as felt by conventional smokers, with symptoms such as itchy throat, cough and complications to the lungs. This literature review conducted a literature search with the keywords cigarette, e-cigarette, popcorn lung, and alveoli. Conventional cigarettes and electronic cigarettes (e-cigarettes) cause damage to the pulmonary alveoli in the form of alveolar spaces; this depends on the nicotine content in them. Electronic cigarettes and conventional cigarettes exert different effects on the oxidative stress response of the airway epithelium. In addition, the image of popcorn lung can be found due to the presence of diacetyl that appears when heating e-juices in e-cigarettes.
Adverse Events Following Immunization of mRNA and Inactivated Vaccines Against COVID-19 at Universitas Indonesia Hospital: A Cross-Sectional Study Vriona Ade Maenkar; Retnosari Andrajati; Nadia Farhanah Syafhan
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.429

Abstract

Background: The coronavirus that causes severe acute respiratory syndrome (COVID-19) is coronavirus 2 (SARS-CoV- 2). This virus has caused a global pandemic. The adverse impact of this virus in the past two years has resulted in efforts to build herd immunity through vaccination. This study aimed to identify the side effects after getting the Pfizer and Sinovac vaccines at the Universitas Indonesia Hospital and the risk factors for Adverse Events Following Immunization (AEFI).Methods: This observational study used a descriptive, non-experimental method with a cross-sectional design. Google Forms was used to collect data.Results: The onset of AEFI symptoms ranged from 15 minutes to 24 hours. The common AEFI symptoms were pain at the injection site, fatigue, muscle aches, and joint pain. The AEFI severity was mostly at the mild level, and only a few participants took medication. Female participants, participants with comorbidities and allergies, previous medication histories within the last 6 months, and those with experience of COVID-19 had a higher risk for AEFI with a statistically significant effect (P <0.005).Conclusion: This study revealed that Pfizer and Sinovac COVID-19 vaccines were safe to administer as the AEFIs were mostly mild and automatically disappeared and decreased after 1 to 3 days.
Simultaneous Bilateral Spontaneous Pneumothorax in an HIV Positive Tuberculosis Patient Arie Gradiyanto Nugroho; Edijono Edijono; Sri Sarwosih Indah Marthaty
Jurnal Respirologi Indonesia Vol 43, No 2 (2023)
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.v43i2.261

Abstract

Background: Even though tuberculosis has been linked to pneumothorax for a long time and has caused significant morbidity and mortality in some patients, it has been the topic of few publications and analyses, thus very little study has been done to evaluate and review on this matter.Case: In this article, we reported a 39-year-old male, presented to the ER with breathlessness for the last 3 days accompanied by increased sputum productivity. The patient had an active pulmonary tuberculosis taht was under treatment, as well as HIV. Physical examination showed low chest expansion, weakened breathing sounds on both lungs, and the use of accessory breathing muscles. The chest X-ray showed bilateral pneumothorax. The patient underwent emergency chest decompression with a 16-gauge needle on both sides, followed by the insertion of an IPC and chest tube. The patient's breathlessness got significantly better, and after 35 days, the IPC was removed.Discussion: Pneumothorax is a frequent complication in Tuberculosis with HIV, with a prevalence of 6.8% compared to 0.95-1.4% in Tuberculosis without HIV. The progression of breathlessness in bilateral pneumothorax on HIV positive Tuberculosis patient is slower, up to 3 days since onset, compared to pneumothorax occured in other etiologies. Secondary pneumothorax usually occurs after extensive destruction of the lungs, leaving a little functionality and lower cardiopulmonary reserve, thus requiring prompt evaluation and more aggresive lifesaving treatment.Conclusion: Based on this case, bilateral pneumothorax found in HIV-associated TB patients comes with an insidious onset but warrants immediate evaluation and aggressive treatment or surgery if necessary.

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