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Jurnal Respirologi Indonesia

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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 241 Documents

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The Proportion of Latent Tuberculosis Infection in Naive Lung Cancer Patients at Persahabatan Hospital Jakarta Erlina Burhan; Ririen Razika Ramdhani; Jamal Zaini
Jurnal Respirologi Indonesia Vol 39, No 4 (2019)
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.v39i4.73

Background: Lung cancer and pulmonary tuberculosis (TB) are two major public health problems associated with significant morbidities and mortalities. The increased prevalence of active TB and latent TB reactivation in lung cancer patients and negative effect of pulmonary TB in lung cancer prognosis needed screening of lung cancer patients for latent TB infection (LTBI). This study aimed to determine the proportion of LTBI in lung cancer patients, their characteristics and the relationship between them. Methods: This study used cross-sectional design. Collecting sample used consecutive sampling of 86 newly diagnosed treatment-naive lung cancer patients from RSUP Persahabatan in 2015 to 2016. The presence of LTBI was determined by Quantiferon-TB Gold-In-Tube (QFT- GIT) after having Mycobacterium TB not detected result from Xpert MTB/RIF sputum test. Demographic characteristics and cancer-related factors associated with LTBI were investigated. Results: The results of latent TB tests were IGRA(+) 12.8%, IGRA(-) 68.6% and IGRA(I) 18.6%. Number of male patients with lung cancer with latent were 68.6%, as many as 55.8% were immunized with BCG, 4.6% had close contact with TB and 64% were using smoking. Most types of cancer were adenocarcinomas (77.9%) with advanced stage (82.6%) and general display status 2 (50%). The characteristics that show an association with IGRA results are the location of the cancer and the total lymphocyte count. Conclusion: The proportion of latent TB in lung cancer patients at the RSUP Persahabatan was 12.8%. The location of the cancer associated with the area of typical TB was related to latent TB, although it cannot be canceled. Results of IGRA(I) in lung cancer patients with low total lymphocyte counts prove IGRA sensitivity in the protection of latent TB infection in immunocompromised patients. (J Respir Indo. 2019; 39(4): 256-65)

The Effects of Allopurinol on Glutathione Sulfhydryl (GSH) Serum Level, Six Minute Walking Test, and CAT Score of COPD Patients Samuel Samuel; Suradi Suradi; Yusup Subagio Sutanto
Jurnal Respirologi Indonesia Vol 39, No 3 (2019)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: Stress oxidative in COPD impairs striated muscle thus worsening COPD symptoms. Allopurinol as antioxidant reduces stress oxidative so it can improve exercise capacity and clinical symptoms. The aims of this study were to analyze the effects of allopurinol on GSH serum level, six minute walking test (6MWT), and COPD assessment test (CAT) score of COPD patients. Methods: This study was a pre and post test clinical trial held in pulmonology outpatient clinic in Dr. Moewardi General Hospital Surakarta from January to February 2018 using purposive sampling. The COPD group C and D patients were cathegorized as intervention group which received allopurinol 300 mg/day for 4 weeks and control group which did not receive allopurinol. Glutathione sulfhydryl serum level, 6MWT, and CAT score were measured at baseline and after 4 weeks in both groups. Results: A total of 37 stable COPD group C and D patients were included in this study. The intervention group showed decreased GSH level (52.58±38.39) µg/ml and CAT score (10.37±4.46) which were statistically significant compared to control group (P

The Agreement Compatibility Level of Tuberculin Skin Test (TST) and POT.TB in Detecting Latent Tuberculosis Infection (LTBI) in Diabetic Mellitus (DM) Sebayang, Pribadi M; Reviono, Reviono; Kartodarsono, Supriyanto
Jurnal Respirologi Indonesia Vol 39, No 4 (2019)
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.v39i4.78

Background: The lifetime risk of TB reactivation develops within the first 5 years after initial infection. Good LTBI management helps in preventing the progression of the disease to be active. It is recommended in countries with a low prevalence of TB infection and high risk populations such as DM patients. The diagnosis of LTBI is done by examining TST and T-SPOT.TB. This study aimed to determine the correspondence between TST and T-SPOT.TB in detecting LTBI in DM patients. Methods: This cross-sectional study was conducted in DM patients treated in Dr. Moewardi Hospital Surakarta in September 2018. The study subjects received TST by injecting intradermal PPD RT 23 2TU intradermally, and T-SPOT.TB by taking 6 ml of venous blood examined with ELISPOT method. Statistical analysis used SPSS21 for windows. Results: There were 30 subjects. The prevalence of LTBI was 20%. The correspondence between TST and T-SPOT.TB was substantial (K=0.667, p

Urinary Cotinine and Expired CO Concentrations in Women Exposed to Environmental Tobacco Smoke at Home Herman Suryatama; Feni Fitriani; Sita Andarini; Agus Dwi Susanto; Achmad Hudoyo
Jurnal Respirologi Indonesia Vol 39, No 3 (2019)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Introduction: The health effects of exposure to environmental tobacco smoke (ETS) using cotinine was a nicotine metabolite detected in urine. This should be recommended as a quantitative measurement of nicotine intake and as biomarker for ETS exposure in humans. Method: We performed a cross-sectional study to 60 ETS-exposed and 58 non ETS exposed adult women in Pasar Rebo area, Jakarta. The urinary cotinine concentrations were measured and analyzed using ELISA method, other informations were collected such as expired CO data, questionnaire regarding smoking habits of the subjects’ family members at home and respiratory health effects occured to subjects. Results: Median of urinary cotinine concentrations in ETS-exposed group were 24.65 ng/ml and 7.30 ng/ml in non-exposed group (P=0.0001). Median of expired CO in ETS-exposed group were 5.00 ppm and 3.00 ppm in non-exposed to ETS group (P=0.0001). Total amount of time (hours/day) in women exposed to ETS in their house was significantly correlated to urinary cotinine concentrations (P=0.037). The respiratory symptoms showed significant correlation with ETS exposure status (P=0.01). Time duration of last exposed to ETS had significant correlation with expired CO (P=0.004). The urinary cotinine concentrations cut-off point was 14.4 ng/ml (sensitivity=75%, specificity=74%, P=0.0001). The expired CO cut-off point was 3.5 ppm (sensitivity=75%, specificity=81%, p=0.0001). Strong and significant correlation was found between expired CO and urinary cotinine (r=0.641, P=0.0001). Conclusion: The urinary cotinine and expired CO concentration were significantly higher in women exposed to tobacco smoke at home than the non-exposed group. Urinary cotinine measurement was a sensitive, non-invasive and effective method to correlate with ETS exposure. (J Respir Indo. 2019; 39(3):140-53)

Improvement of Anxiety, Coughing, Breathlessness and Pain Control in The Management of Bronchoscopy by Adding Alprazolam Yanny Octavia Sally Ride; Yusup Subagio Sutanto; Debree Septiawan
Jurnal Respirologi Indonesia Vol 39, No 4 (2019)
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.v39i4.74

Background: Anxiolytic premedication can reduce anxiety, improving procedural tolerance, and reduce postbronchoscopic complications. There was ongoing debate about the safety of bronchoscopist-administered sedation. Alprazolam as a surgical premedication can reduce anxiety. Alprazolam can be used as an adjuvant analgesic, to reduce anxiety-related breathlessness, and to reduce coughing as adjuvant antitussive. The study aimed to evaluate the effectiveness of alprazolam in patients undergoing bronchoscopy. Methods: A clinical study with experimental quasi pre-post test control group design, using consecutive sampling was performed in patients with lung tumor undergoing bronchoscopy in dr.Moewardi Hospital from February to March 2019. The study subjects were divided in experimental (alprazolam) and control groups (without alprazolam). The Hospital Anxiety and Depression Scale (HADS), VAS for pain score, modified Borg score, and VAS for cough were measured in baseline, before, and after bronchoscopy. Results: Thirty two lung subjects were included in this study. The intervention groups showed decreased HADS score pre and post bronchoscopy (6.56±2.83 and 6.88±2.63), pain VAS scores (15.00±10.95 and 9.69±11.61), cough VAS score (11.56±8.89 and 27.19±17.89), and these were different significantly compared to control group. We found decreased mean of modified Borg in the study group though they were not significant compared to the control group. Conclusion: Alprazolam controlled anxiety, coughing, and pain in patients undergoing bronchoscopy. Alprazolam minimized breathlessness after bronchoscopy. (J Respir Indo. 2019; 39(4): 245-55)

Immunogenicity Test of ESAT-6/CFP-10 Mycobacterium tuberculosis (Indonesian Strain) Recombinant Protein Fusion: TNF-α, IL-17 and CD4+ T Cells Expression in PBMC Culture Eko Prasetyo; Triwahju Astuti; Nunuk Sri Muktiati; Maimun Z Arthamin
Jurnal Respirologi Indonesia Vol 39, No 3 (2019)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: Bascillus Calmette Guѐrin vaccination has not provided protection against TB in adults. ESAT-6/CFP-10 Mtb recombinant protein fusion as a vaccine candidate can stimulate the body's immune response. Interleukin-17, TNF-α and CD4+ play a major role against TB. This study aims to determine that the recombinant protein fusion ESAT-6/CFP-10 Mtb can stimulate TNF-α, IL-17 and CD4+ T cells expression in PBMC culture. Methods: Design of this study is experimental study. Number of research sample per group of 8 subjects. The subjects: healthy, TB contact and TB patients were taken their peripheral blood sample and treated with ESAT-6/CFP-10 Mtb recombinant protein fusion. TNF-α CD4+ T cells were measured by ELISA. Flow cytometry is used to measure IL-17 and CD4+ Tcells. As standard protocol research on tuberculosis vaccine, each subject also treated without antigen and with PPD. Results: There was no significant increase in the administration of ESAT-6/CFP-10 Mtb fusion compared without antigen on TNF-α expression of CD4+ (P=0.202), expression of IL-17 CD4+ (P=0.994) and percentage of CD4+ T cells (P=0.183). ESAT-6/CFP-10 Mtb Fusion was able to stimulate expression of TNF-α CD4+ in healthy subjects (29.91±1.23pg/ml), TB contact (32.21±4.02pg/ml) and TB patients (33.35±8.41 pg/ml). Expression IL-17 CD4+ in healthy subjects (33.24 ± 39.01%), TB contact (23.88 ± 21%) and TB patients (51.93 ± 36%). CD4+ T cell expression in healthy subjects 30.64 ± 7.63%, TB contact 24.58 ± 5.24% and TB patients (40.73±2.63%). Conclusions: ESAT-6/CFP-10 Mtb recombinant proteins fusion may stimulate the production of TNF-α, IL-17 CD4+ and CD4+ T cells in all subject. Expression of TNF-α, IL-17 CD4+ and CD4+ T cells in the healthy group, indicated that the ESAT-6/CFP-10 recombinant protein fusion has the potential as vaccine candidate. (J Respir Indo. 2019; 39(3):160-8)

Pulmonary Mycoses in Indonesia: Current Situations and Future Challenges Anna Rozaliyani; Anwar Jusuf; Priyanti ZS; Erlina Burhan; Diah Handayani; Henie Widowati; Satria Pratama; Findra Setianingrum
Jurnal Respirologi Indonesia Vol 39, No 3 (2019)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Cases of pulmonary mycosis or pulmonary fungal diseases continues to increase in frequency along with the expanding population with impaired immune systems, including patients with pre-existing pulmonary diseases. Changing profile of underlying diseases might cause altering diseases profile as well. In previous decades, Pneumocystis pneumonia was the most common pulmonary mycosis in HIV-infected patients. As the increasing number of TB cases, pulmonary malignancy, chronic obstructive pulmonary disease (COPD) and certain chronic diseases, other pulmonary mycoses also increase such as chronic pulmonary aspergillosis, cryptococcosis, histoplasmosis, and other filamentous fungal infection. Furthermore, the airborne fungal particles of Aspergillus and other fungi could seriously worsen asthma or allergic respiratory diseases. In low- and middle-income countries, including Indonesia, lack of diagnostic facilities may lead to inadequate treatment. It will contribute to poor clinical outcomes with high mortality rates. The awareness among clinicians and other health workers of this epidemiology changes is the important step in early diagnosis and better managemenet of pulmonary mycosis in the future. (J Respir Indo. 2019; 39(3): 210-4)

Hypnotherapy Effectiveness in Bronchoscopy to Control Anxiety, Breathlessness and Cough Teguh Budi Santosa; Yusup Subagio Sutanto; Debree Septiawan
Jurnal Respirologi Indonesia Vol 39, No 1 (2019)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: Patient’s comfort during bronchoscopy is important, as it affects its success and the whole outcome. The short comings of bronchoscopy with general anesthesia are long procedure, high cost, and its complication in respiratory failure patient’s. Hypnosis in various surgery procedures can reduce anxiety. Hypnosis can also be used as a therapy for shortness of breath and chronic cough. This study aimed to analyze the effectiveness of hypnotherapy in controling anxiety, breathing shortness a cough of patient’s undergoing bronchoscopy. Methods: This research is a clinical trial with a quasi-experimental design using the pretest-posttest control group approach using consecutive sampling was performed in patients with lung tumor undergoing bronchoscopy in dr. Moewardi Hospital from July to August 2018. The study subjects were randomized in to hypnotized and non-hypnotized (control groups). Scores of Hospital Anxiety and Depression Scale (HADS), modified Borg, and cough Visual Analog Scale (VAS) were measured before and after bronchoscopy. Results: Thirtyseven lung tumor patient’s undergoing bronchoscopy were included in our study. The intervention groups showed decreased HADS (6,68+8,28) and different significantly compared to control group (p

Longitudinal Study Of BODE Index As Predictive Factor of COPD In Persahabatan Hospital Jakarta Isep Supriyana; Faisal Yunus; Budhi Antariksa; Aria Kekalih
Jurnal Respirologi Indonesia Vol 39, No 4 (2019)
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.v39i4.75

Background: The BODE index is generally used for predicting mortality risk of COPD patients. The BODE index included the body mass index, degree of airflow obstruction (FEV1), dyspnea (MMRC questionnaire), and exercise capacity (6-minute walk test). Exacerbation of COPD associated with decreased health related quality of life (HRQoL). HRQoL has become an important outcome in respiratory patients as proved by St.George’s Respiratory Questionnaire (SGRQ). This study aim to find the correlation between BODE index with exacerbation and quality of life of COPD patients. We hypothesized that the higher BODE index score, the more frequent exacerbation occurrence and HRQoL decreased. Methods: Prospective cohort study of COPD patients was conducted in Persahabatan Hospital in November 2010 till June 2011. This study assessed the BODE index (at baseline) and followed at 3, 6, 9 and 12 months. Patient were also examined with SGRQ at baseline and followed at 6 and 12 months. We monitored the occurrence of exacerbation every month by telephone, observed their medical record, or visited the COPD’s clinic and emergency departement. Results: Eighty-five patients were examined at baseline with mean of BODE index 4.29 and SGRQ total score 41.42%. After one year follow up 52 patients have completed examination, 29 patients have not complete examination and 4 patients died. Using t-test analysis the correlation of BODE index between single and frequent exacerbation was significant (P

Digital Index of The Fingers with Digital Clubbing: An objective measurement to diagnose clubbed finger. Rahardjo Darmanto Djojodibroto; Asri Said; Nurul Shahirah AS; Sim Chun Yang
Jurnal Respirologi Indonesia Vol 39, No 3 (2019)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Introduction: Digital clubbing can often be found as a clinical sign in patients with various underlying diseases. However, early signs of clubbing are often overlooked. To determine the Digital Index values from the fingers with clinical features of clubbing of varies conditions background. Method: This was a prospective, case-series, investigator-initiated observation by morphometry, conducted in Kuching, Malaysia along 6 months duration. Participants were 46 patients with varies stage of clubbing of varies conditions and diseases. We measured the finger at the circumference of the Nail Fold and Distal Interphalangeal joint which determined the value of the Digital Index of a population with finger clubbing. Results: The value of the Digital Index of finger clubbing in this study was 9.89±0.68 (Mean±SD) for male and 9.87±0.39 (Mean±SD) for female. The value of the Digital Index of finger clubbing for all subjects together was 9.88±0.56 (Mean±SD) with a range of 8.43 to 11.26. Conclusion: Early clubbing often be overlooked. To avoid such condition, the physician should examine the fingers as a routine procedure. Measurement of DI can be recommended to detect early clubbing. (J Respir Indo. 2019; 39(3):196-204)

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