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"ABSTRAKPendahuluan:Penggunaan kortikosteroid KS inhalasi dalam tatalaksana penyakit paru obstruktif kronik PPOK diduga berkaitan dengan risiko pneumonia. Penelitian yang ada memberikan hasil yang tidak konsisten. Belum jelas pengaruh perbedaan jenis, dosis, dan durasi KS terhadap pneumonia. Hal tersebut mendasari pentingnya mengetahui hubungan dan pengaruh pola penggunaan KS inhalasi dengan kejadian pneumonia. Metode:Penelitian kasus kontrol retrospektif ini menggunakan data rekam medik pasien PPOK yang di rawat inap dan jalan di RSUPN Dr.Ciptomangunkusumo dan RS Dr.Ciptomangunkusumo Kencana periode 1 Januari 2012 sampai 30 November 2016. Kelompok kasus dipilih acak dari pasien dengan pneumonia yang ditunjang data radiologis n=67 . Kontrol dipasangkan berdasarkan kategori usia dan penyakit penyerta dengan kasus n=67 . Pada kedua kelompok dinilai pajanan dan pola penggunaan kortikosteroid, lalu dianalisis deskriptif dan analitik. Hasil:Terdapat perbedaan gambaran pajanan kortikosteroid pada kasus dan kontrol. Terdapat hubungan penggunaan kortikosteroid dengan pneumonia p 0,005;OR 0,31;95 CI 0,13-0,71 . Pajanan kelompok kasus didominasi oleh flutikason propionat, sedangkan kontrol adalah budesonid. Tidak ada hubungan jenis dengan pneumonia. Penggunaan terbanyak dosis rendah dan durasi 1 bulan. Ada hubungan dosis dengan pneumonia p 0,019 , tetapi tidak dengan durasi p 0,683 . Kesimpulan:Kortikosteroid inhalasi mempunyai efek antiinflamasi dan imunosupresan. Pajanan kortikosteroid bersifat protektif karena digunakan dengan dosis rendah sehingga meminimalkan risiko pneumonia.

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ABSTRACTIntroduction Treatment with inhaled corticosteroids ICS is well established for chronic obstructive pulmonary disease COPD , but might be linked to pneumonia. However, results differed widely between studies. The magnitude of risk and how this compares with different ICS, dose, and duration, remain unclear. The objective of this study was to determine if the use of ICS is associated with pneumonia and impact of different ICS regiment. Method A retrospective, case ndash control study was conducted using medical record data of COPD patient at RSUPN Dr.Ciptomangunkusumo and RS Dr.Ciptomangunkusumo Kencana January 1 rsquo 2012 November 30 rsquo 2016 . Sixty seven patient with radiographically confirmed pneumonia cases were matched to 67 controls by age and comorbid. Statistical analysis used to estimate the odds ratio OR and impact of different ICS regiment. Result There are differences in ICS exposure between cases and controls. Treatment with ICS is protective p0.005 OR0.31 95 CI0.13 0.71 . Exposure to ICS in case was dominated by fluticasone propionate and budesonide in control. There is no relationship between types of ICS with pneumonia. Mostly ICS are used in low dose and short duration. There is a relationship between dose with pneumonia p0.019 , but not with duration p0.683 . Conclusion ICS has antiinflammation and immunosuppressant effect. ICS shows protective effect due to lower dose use."

"Latar belakang: Eksaserbasi PPOK berhubungan dengan dampak yang cukup besar pada kualitas hidup dan aktivitas sehari-hari. Mayoritas pasien mengalami setidaknya satu eksaserbasi per tahun dan eksaserbasi telah dikaitkan dengan penurunan progresif dalam VEP1 dan dengan laporan yang berbeda-bedaada ketidakpastian apakah eksaserbasi meningkatkan tingkat penurunan fungsi paru.Metode: Penelitian ini penelitian deskriptif dengan metode potong lintang yang menganalisis hasil spirometri pada pasien PPOK dan membandingkan dengan data spirometri tahun sebelumnya dan melihat perubahan VEP1. Jumlah sampel keseluruhan penelitian ini adalah 100 pasien yang sudah terdiagnosis PPOK dan rutin kontrol ke poli asma/PPOK RS persahabatan dari tahun 2011sampai 2013. Hasil: Sebanyak 100 subjek diambil untuk penilitian ini. Sebagian besar pasien adalah laki-laki , 96 % ( n = 96 ) . Usia rata-rata adalah 66,5 tahun ( SD ± 7 tahun dan 95 % CI ) BMI subjek adalah 22.88 ( SD ± 3,95 & 95% CI ). Status merokok adalah; bekasperokok ( 89 %, 95 % CI ), merokok 3 %, dan 8 % yang tidak pernah merokok. Keparahan penyakit berdasarkan GOLD adalah; Derajat ringan 7 %, Sedang 45 %, berat 41% dan sangat berat 7 %. Penurunan VEP1terlihat pada 73 % subjek ( n = 73 ) dan penurunan VEP1 rata-rata 117mL per tahun. Subjek dalam penelitian kami ditemukan eksaserbasi tingkat tahunan rata-rata 2,4 per tahun. Kami idak menemukan korelasi yang bermakna dengan jumlah eksaserbasi dengan jumlah eksesabasi( p = 0,005) dan terdapat korelasi yang bermakna dengan jumlah eksaserbasi dan tingkat keparahan penyakit (p = 0,005 ). Kami tidak menemukan korelasi penurunan VEP1 dengan BMI (p = 0,602 ), Indeks Brinkman (p = 0,462) atau komorbiditi. Kesimpulan: Penilitian ini terdapat hubungan yang bermakna dengan penurunan VEP1 dan tingkat keparahan penyakit dengan frekuensi eksaserbasi. Kami tidak menemukan hubungan yang bermakna dengan jumlah eksesabasi dengan BMI, Brinkman Index atau komorbiditi.

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Introduction: Exacerbations of COPD are associated with considerable impact on quality of life and daily activities. The rate at which exacerbations varies greatly between patients. Majority of patients experience at least one exacerbation per year and exacerbations have been linked to a progressive decline in FEV1and with varying reports there is uncertainty as to whether exacerbations increase the rate of decline in lung function.

Method: We conducted a descriptive, cross-sectional study on COPD patients who were on regular follow up at our hospital since 2011. Spirometry at enrollment was compared with previous year’s spirometry and event-based exacerbations were inquired from the patient and from inpatient and outpatient hospital medical records.

Result: A total of 100 patients were included in the study. Majority of patients were males, 96% (n= 96). The mean age was 66.5 years (SD ±7 years and 95% CI) The BMI of the subjects was 22.88 (SD± 3.95 & at 95% CI). Smoking status of the subjects were; past smokers (89%, 95% CI), current smokers, 3%, and 8% who never smoked. Disease severity per GOLD were; Mild disease 7%, Moderate 45%, Severe 41% and very Severe 7%. Decline in FEV1 was observed in 73% subjects (n=73) and a mean decline of 117mL/year. Subjects in our study reported 288 exacerbations during the study with a mean annual exacerbations rate of 2.4 per year. FEV1 decline hada significant correlation with number of exacerbations (p=.0005) and also there was significant relationship with disease severity (p=0.005). We did not find a correlation of decline in FEV1 with BMI (p=.602), Index Brinkman (p=.462) or comorbidities.

Conclusion: There was a significant correlation with decline in FEV1 and disease severity with the total number of exacerbations. We also found a significant correlation with disease severity as per GOLD stage,however, we did not find a significant correlation between BMI, Brinkman Index or the comorbidities of the subjects with number of exacerbations."

"ABSTRAKLatar belakang: Penyakit paru obstruktif kronik merupakan penyebab utama morbiditas dan mortalitas di dunia. Penyakit komorbid pada PPOK berkontribusi terhadap rendahnya status kesehatan, mempengaruhi lama perawatan bahkan kematian. Osteoporosis merupakan komorbid yang cukup sering ditemukan pada PPOK. Di Indonesia khususnya di RSUP Persahabatan belum ada data prevalens osteoporosis pasien PPOK stabil.Objektif: Tujuan penelitian ini adalah mendapatkan angka prevalens osteoporosis pada pasien PPOK stabil di RSUP Persahabatan Jakarta.Metode: Disain penelitian ini adalah potong lintang. Pasien PPOK stabil yang berkunjung di poliklinik Asma/PPOK RSUP Persahabatan yang memenuhi kriteria inklusi dan eksklusi. Subjek diperiksa densitas mineral tulang menggunakan dual energy x-ray absorptiometry (DXA) dan diperiksa kadar vitamin D darah. Saat pasien berkunjung, dilakukan anamnesis gejala, eksaserbasi, riwayat merokok, penggunaan kortikosteroid (oral atau inhalasi), komorbid, penilaian status gizi. Selanjutnya dilakukan analisis dengan uji statistik.Hasil: Subjek terbanyak adalah laki-laki (90,6%) dengan kelompok usia 65-75 tahun (53,1%), riwayat merokok terbanyak (84,4%). Berdasarkan derajat PPOK terbanyak adalah GOLD II (46,9%) dan grup B (50%) dengan menggunakan kortikosteroid sebanyak (65,7%). Pada penelitian ini didapatkan prevalens osteoporosis sebesar 37,5%, artinya lebih dari sepertiga pasien mengalami osteoporosis. Dalam Penelitian ini tidak terdapat hubungan bermakna secara statistik antara grup PPOK, derajat PPOK, jenis kelamin, riwayat merokok, riwayat kortikosteroid, usia, kadar 25-OHD, faal paru dengan terjadinya osteoporosis pada pasien PPOK stabil (p>0,05). Pada penelitian ini didapatkan hubungan bermakna pada IMT yang rendah sebagai faktor risiko osteoporosis pada PPOK stabil (p<0,001).Kesimpulan: Prevalens osteoporosis pada pasien PPOK stabil di RSUP Persahabatan Jakarta adalah 37,5%. Terdapat hubungan yang bermakna secara statistik antara IMT dengan osteoporosis pada pasien PPOK stabil (p<0,001).

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ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Comorbid diseases in COPD contributing to low health status, affecting the duration of treatment and even death. Osteoporosis is a quite often comorbid that found in COPD. In Indonesia, particularly in Persahabatan Hospital there are no data of prevalence on osteoporosis in patient with stable COPD.

Objective: The purpose of this research is to get the prevalence?s data of osteoporosis in patients with stable COPD at Persahabatan Hospital-Jakarta.

Method: The studie?s design was cross-sectional. Patients with stable COPD who came to the Asthma/COPD policlinic at Persahabatan Hospital-Jakarta who meet the criteria of inclusion and exclusion. Subjects had an examined of bone mineral density using dual energy x-ray absorptiometry (DXA) and had an examined of vitamin D blood level. At the time of visit, conducted anamnesis of symptoms, exacerbations, history of smoking, used of corticosteroid (oral or inhaled), comorbid, assessment of nutritional status. Then we did statistical test for analysis.

Results: Subjects were dominated with male (90.6%) in the age group 65-75 years old (53.1%), and smoking history (84.4%). The most degree of COPD of the subject were GOLD II (46.9%) and group B (50%) that using corticosteroid (65.7%). In this study we found prevalence of osteoporosis was 37.5%, meaning that approximately more than one third of the patients have had osteoporosis. There were no statistically significant relationship between COPD group, the degree of COPD, sex, smoking history, history of corticosteroid, age, levels of 25-OHD, pulmonary function with the occurrence of osteoporosis in patients with stable COPD (p>0.05). We found a significant relationship on low BMI as a risk factor for osteoporosis in stable COPD (p<0.001).

Conclusion: The prevalence of osteoporosis in patients with stable COPD in Persahabatan Hospital-Jakarta is 37.5%. There are a statistically significant relationship between BMI with osteoporosis in patients with stable COPD (p <0.001)."

"Latar belakang: Diabetes melitus tipe 2 merupakan penyakit komorbid yang sering ditemui pada pasien PPOK. Penyakit paru obstruktif kronik dipertimbangkan sebagai faktor risiko berkembangnya diabetes tipe 2 melalui beberapa mekanisme antara lain inflamasi sitemik, merokok, stres oksidatif, obesitas dan penggunaan kortikosteroid inhalasi. Prevalens DM pada pasien PPOK di Indonesia belum diketahui secara pasti. Diabetes melitus sebagai penyakit komorbid pada pasien PPOK akan mempengaruhi morbiditas dan mortalitas pasien PPOK. Metode: Penelitian ini merupakan penelitian potong lintang dengan analisis deskriptif yang dilakukan di poliklinik asma ndash;PPOK Rumah sakit umum pusat Persahabatan pada bulan Februari ndash; Maret 2017 untuk melihat kejadian diabetes pada pasien PPOK. Enam puluh empat pasien PPOk di ambil untuk ikut dalam penelitian ini secara consecutive sampling. Pada semua pasien dilakukan wawancara, pemeriksaan fisis dan pemeriksaan laboratorium. Hasil: Pada penelitian ini diambil 64 pasien PPOK lakilaki: 60, perempuan : 4 dengan usia rata rata 65 8.7 tahun. Sebanyak 12 subjek 18.8 sudah memiliki riwayat DM sebelumnya dan pasien ini dimasukan kedalam kelompok DM tanpa memandang hasil laboratorium. Dari 52 81.3 subjek yang belum diketahui status DM ditemukan 2 subjek 3,1 dengan diagnosis DM. Prevalens DM pada pasien PPOK pada penelitian ini sebesar 21.9. Ditemukan 16 subjek 25 dengan kadar HbA1c sesuai dengan prediabetes. Tidak ditemukan hubungan bermakna antara usia, jenis kelamin, riwayat merokok, sataus gizi, hambatan aliran udara dan penggunaan kortikosteroid inhalasi dengan kejadian DM pada pasien PPOK. Kesimpulan: Prevalens DM pada pasien PPOK dalam penelitian ini adalah sebesar 21..9 . Penapisan komorbid DM penting dilakukan secara berkala.

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Background: Type 2 diabetes mellitus DM is a common comorbidity of COPD. COPD may be considered as a risk factor for new onset type 2 DM via multiple pathophysiological alterations such as systemic inflammation, smoking, oxidative stress, obesity and inhaled corticosteroid use. Exact prevalence of DM in COPD patients in Indonesia are still unclear. Co morbid conditions like DM have great impacts on the outcome of COPD in the form of severity, morbidity and mortality

Method: A cross sectional study with descriptive analysis was done in Asthma COPD clinic Persahabatan Hospital from February to March 2017 to screen COPD patients for DM. Sixty four subjects were recruited consecutively. Interview, physical examination and laboratory testing were performed in all subjects.

Results: A total of 64 patients with COPD Males 60, Female 4 with mean age 65 8.7 were screened for DM. Patients with known history of DM were 12 18.8 and were enrolled as Known DM cases. Remaining 52 81.3 patients whose DM status were unclear and screened by random or fasting blood sugar and HbA1c. Two subjects 3.1 were considered as newly diagnosed DM cases. Prevalence of DM in present study was 21.9. Number of patients with prediabetes were 16 subjects 25. There were no significant relationship among gender, age, smoking, nutritional status, airflow limitation and inhaled corticosteroid use in occurrence of DM among COPD patients.

Conclusion: Prevalence of DM in COPD patients in the present study is 21.9. It is important to screen all COPD patients for DM routinely. "

"Penyakit Paru Obstruktif Kronik (PPOK) merupakan penyebab kematian nomor 4 di dunia. PPOK mengganggu proses masuk dan keluarnya udara sehingga dapat menimbulkan gejala seperti batuk, sesak, dan produksi sputum berlebih. Aktivitas fisik penting untuk pasien PPOK. Aktivitas fisik dapat mengurangi risiko hospitalisasi dan mortalitas. Tujuan penelitian ini, yaitu melihat gambaran karakteristik dan aktivitas fisik pada pasien PPOK. Penelitian ini menggunakan desain penelitian cross-sectional pada 200 responden dengan teknik purposive sampling. Alat pengumpulan data menggunakan International Physical Activity Questionnaire (IPAQ) untuk aktivitas fisik. Hasil penelitian didapatkan 66 orang (33%) aktivitas fisik ringan, 74 orang (37%) aktivitas fisik sedang, dan 60 orang (30%) aktivitas fisik berat. Pada 200 orang responden yang mengikuti penelitian ini paling banyak melakukan aktivitas fisik sedang, sehingga mayoritas responden aktivitas fisiknya terpenuhi. Pada aktivitas fisik ringan disarankan untuk menggunakan bronkodilator sebelum beraktivitas atau mengikuti rehabilitasi paru sehingga dapat meningkatkan aktivitas fisik.

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Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the world. COPD interferes with air entry and discharge, causing symptoms such as coughing, dyspnea, and excessive sputum production. Physical activity is important for COPD patients. Physical activity could reduce the risk of hospitalization and mortality. This study is aimed to describe the characteristic of physical activity on patients with COPD. Its design was cross-sectional with 200 samples and selected through purposive sampling technique. Physical activity were identifies using International Physical Activity Questionnaire (IPAQ). The results showed there were 66 patients (33%) who had mild physical activity, 74 patients (37%) with moderate, and 60 patients (30%) which had severe physical activity. This study found that the majority of patients had a good physical activity. This study reccomends patients with mild physcial activity uses bronchodilator before joining the lung rehabilitation or other activities to improve the intensity of physical activity."

"Penurunan fungsi paru berperan pada peningkatan insiden PPOK  pada lansia. Penurunan fungsi kognitif dapat mempengaruhi ketepatan penggunaan inhaler dapat berdampak negatif terhadap prognosis. Tujuan Penelitian mengetahui hubungan fungsi kognitif dengan ketepatan penggunaan inhaler pada lansia PPOK. Metode penelitian menggunakan cross sectional dengan lokasi penelitian di poliklinik Paru Asma-PPOK. Sampel pada penelitian dipilih melalui teknik consecutive sampling berjumlah 96 responden lansia PPOK. Analisis data terdiri dari analisis univariat, analisis bivariat menggunakan uji Chi-square dan analisis multivariat menggunakan uji Regresi Logistik. Hasilnya responden mengalami gangguan fungsi kognitif dengan kategori tidak tepat dalam penggunaan inhaler sebanyak 46 responden (55.2%). Uji statistik regresi logistik didapatkan variabel fungsi kognitif berhubungan dengan ketepatan penggunaan inhaler (p=0,001; OR=40,524; CI 95% 12,537- 130,984). Kesimpulan ada hubungan antara fungsi kognitif dengan ketepatan penggunaan inhaler pada lansia PPOK setelah dilakukan uji statistik. Lansia mengalami gangguan fungsi kognitif tidak optimal dalam penggunaan inhaler. Pemberian edukasi pada lansia serta keluarga/caregiver dengan metode disesuaikan kemampuan kognitif lansia, seperti demonstrasi langsung, video instruksional, dan materi visual.

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Decreased lung function contributes increased incidence of COPD in older adults. Impairment cognitive function affect accuracy of inhalers could have bad prognosis. Aim of study was to determine relationship between cognitive function with accuracy of inhaler usage in older adults with COPD. The research method used cross sectional location at polyclinic Asma-PPOK. The respondents were selected method through consecutive sampling technique, totalling 96 older adults with COPD. Data analysis consisted of univariate analysis, bivariate analysis using the Chi-square / Pearson Chi-square test, and multivariate analysis using the Logistic Regression test. Result respondents impaired cognitive function with inappropriate  use of inhalers as many as 46 respondents (55.2%). Logistic regression statistical obtained cognitive function correlated with accuracy of inhaler use (p=0.001; OR=40.524; CI95% 12.537- 130.984). Conclusion there correlation between cognitive function with accuracy of inhaler usage in older adults with COPD after statistical analysis. Older adults with impaired cognitive function are not optimal use inhalers. Providing education to older adults and caregivers by methods adjusted cognitive function, such as direct demonstrations, instructional videos, and visual materials."

"[ABSTRAKPenyakit paru obstruktif kronik (PPOK) merupakan penyebab utama morbiditas dan mortalitas di dunia.Beberapa faktor risiko PPOK juga merupakan faktor risiko terjadinya tuberkulosis (TB).Beberapa penelitian di luar ditemukan prevalens TB paru pada pasien PPOK sekitar 2,6% - 10%.Indonesia khususnya di RSUP Persahabatan belum ada data proporsi TB paru pada pasien PPOK.Objektif: tujuan penelitian ini adalah mendapatkan angka proporsi TB paru pada pasien PPOK di RSUP Persahabatan Jakarta.Metode: desain penelitian ini adalah potong lintang. Pasien PPOK (belum diobati dengan obat anti tuberkulosis) yang berkunjung di poliklinik Asma/PPOK RSUP Persahabatan yang memenuhi kriteria inklusi dan eksklusi.Subjek diperiksa dahak BTA dan pemeriksaan Xpert MTB/RIF. Saat pasien berkunjung, dilakukan anamnesis gejala, eksaserbasi, riwayat merokok, penggunaan kortikosteroid (oral atau inhalasi), komorbid, skor CAT, penilaian status gizi, spirometri dan foto toraks. Semua data dilakukan analisis dengan uji chisquare.Hasil: subjek terbanyak adalah laki-laki (97,3%) dengan kelompok usia 60-79 tahun (74,3%), dengan komorbid terbanyak penyakit jantung (41,9%), gejala klinis terbanyak batuk berdahak (81,1%). Berdasarkan derajat PPOK terbanyak adalah GOLD 3 (44,6%) dan frekuensi eksaserbasi tersering 0-1 (78,4%) dengan menggunakan steroid sebanyak 59,5%. Pada penelitian ini didapatkan pemeriksaan dahak BTA positif 1,4% dan Xpert MTB/RIF positif 2,7%, artinya pemeriksaan Xpert MTB/RIF mempunyai angka kepositifan lebih tinggi dibanding dahak BTA. Dalam penelitian ini didapatkan proporsi TB paru pada pasien PPOK sebanyak 2,7%.Dalam Penelitian ini tidak terdapat hubungan bermakna secara statistik antara derajat PPOK, status gizi, penggunaan kortikosteroid, status merokok dengan prevalens TB paru pada pasien PPOK (p > 0,05).Pada penelitian ini didapatkan hubungan bermakna pada frekuensi eksaserbasi PPOK, hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru (p < 0,05).Kesimpulan: proporsi TB pada pasien PPOK di RSUP Persahabatan Jakarta adalah 2,7%. Terdapat hubungan yang bermakna secara statistik antara frekuensi eksaserbasi PPOK dengan proporsi TB paru pada pasien PPOK (p = 0,0006). Terdapat hubungan yang bermakna secara statistik antara hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru pada pasien PPOK dengan nilai p < 0,05 (p = 0,000).

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ABSTRACTChronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Some of the risk factors for COPD are also risk factors for tuberculosis (TB). Some studies abroad have found the prevalence of pulmonary tuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence of pulmonary tuberculosis patients with COPD in Indonesia, particularly in The Department of Pulmonology PersahabatanHospital, Jakarta. Objective: the purpose of this study is to obtain proportion of pulmonary TB in COPD patients in The Department of Pulmonology Persahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients (anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic PersahabatanHospital which meet the inclusion and exclusion criteria. Subjects went through acid-fast bacilli sputum smear and Xpert MTB/RIF examination. On patients visit, symptoms, exacerbations history, history of smoking, use of corticosteroids (oral or inhaled), comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-ray data had been obtained. All data were analyzed with chi-square test. Results: most subjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly found comorbid was heart disease (41.9%), and mostly found clinical symptoms was productive cough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the most exacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In this study, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive 2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFB sputum smear. The proportion of pulmonary tuberculosis in patients with COPD was 2.7%. We also found no statistically significant relationship between classification of COPD, nutritional status, use of corticosteroids, smoking status with the proportion of pulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant difference in the exacerbations frequency of COPD, the results of sputum smear examination and the results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05).Conclusion: the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is astatistically significant difference between the frequency of exacerbations of COPD with proportion of pulmonary TB in patients with COPD (p = 0.0006). An association is statistically significant different between the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000)., Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity andmortality in the world. Some of the risk factors for COPD are also risk factors fortuberculosis (TB). Some studies abroad have found the prevalence of pulmonarytuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence ofpulmonary tuberculosis patients with COPD in Indonesia, particularly in The Departmentof Pulmonology Persahabatan Hospital, Jakarta. Objective: the purpose of this study is toobtain proportion of pulmonary TB in COPD patients in The Department of PulmonologyPersahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients(anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic Persahabatan Hospitalwhich meet the inclusion and exclusion criteria. Subjects went through acid-fast bacillisputum smear and Xpert MTB/RIF examination. On patients visit, symptoms,exacerbations history, history of smoking, use of corticosteroids (oral or inhaled),comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-raydata had been obtained. All data were analyzed with chi-square test. Results: mostsubjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly foundcomorbid was heart disease (41.9%), and mostly found clinical symptoms was productivecough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the mostexacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In thisstudy, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFBsputum smear. The proportion of pulmonary tuberculosis in patients with COPD was2.7%. We also found no statistically significant relationship between classification ofCOPD, nutritional status, use of corticosteroids, smoking status with the proportion ofpulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant differencein the exacerbations frequency of COPD, the results of sputum smear examination andthe results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05). Conclusion:the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is a statistically significant differencebetween the frequency of exacerbations of COPD with proportion of pulmonary TB inpatients with COPD (p = 0.0006). An association is statistically significant differentbetween the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000).]"

"PPOK merupakan penyakit yang bersifat kronis, irreversible, dan progresif lambat semakin lama semakin memburuk. Hal tersebut membuat pasien PPOK mengalami ketergantungan terhadap obat dan orang lain, sehingga rentan mengalami gangguan status emosional. Maka, peneliti tertarik untuk mengetahui hubungan antara dukungan sosial dengan status emosional pada pasien PPOK. Teknik pengambilan sampel yang digunakan dalam penelitian ini adalah teknik consecutive sampling. Data diolah menggunakan perangkat lunak dengan menggunakan uji statistik Chi Square. Hasil analisis hubungan antara dukungan sosial dengan status emosional pada pasien PPOK menunjukkan bahwa tidak terdapat hubungan antara dukungan sosial dengan status emosional depresi p=0.921, status emosional kecemasan p=0.184, dan status emosional stress p=0.795. Namun, peneliti menyarankan pada rumah sakit agar melakukan skrinning status emosional pada setiap pasien, khususnya pasien PPOK agar dapat mencegah terjadinya perburukan.

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COPD is a chronic disease, irreversible, slow progressive disease progressively worsens. This makes the COPD patient dependent on drugs and others, so vulnerable to emotional status disorders. So, researchers interested to know the relationship between social support with emotional status in patients with COPD. The sampling technique used in this research is consecutive sampling technique. Data is processed using software using Chi Square statistical test.

The analysis of the relationship between social support and emotional status in COPD patients showed no association between social support with emotional status depression p 0.921, emotional status anxiety p 0.184, and emotional status stress p 0.795 . Horever, investigators suggest that the hospital should screen for the emotional status of each patient, especially in the case of COPD to prevent worsening."

"Penyakit Paru Obstruktif Kronik PPOK merupakan penyakit dengan penurunan fungsi paru, yang melibatkan stres oksidatif pada patogenesisnya. Likopen diketahui merupakan salah satu karotenoid utama pada jaringan paru dengan aktivitas antioksidan sangat kuat. Penelitian potong lintang ini dilakukan di RSUP Persahabatan, Jakarta Timur, melibatkan 47 subjek dengan tujuan mengetahui korelasi antara kadar likopen serum dengan fungsi paru pada penderita PPOK. Karakteristik subjek dan asupan likopen didapatkan melalui wawancara menggunakan food frequency questionairre FFQ semi-kuantitatif. Kategori diagnosis PPOK didapatkan dari rekam medis atau wawancara. Status gizi ditentukan berdasarkan Indeks Masa Tubuh IMT , fungsi paru ditentukan menggunakan spirometri, dan kadar likopen serum diukur dengan High Performance Liquid Chromatography HPLC . Semua subjek laki-laki, terbanyak berusia ge;60 tahun, hampir separuh bekas perokok berat, 51 berstatus gizi normal. Asupan likopen 4.407 256 ndash;18.331 mg/hari, lebih rendah daripada asupan orang sehat. Kadar likopen serum 0,57 0,25 mmol/L, setara dengan orang sehat. Terdapat korelasi positif p=0,001; r=0,464 antara kadar likopen serum dengan VEP1/KVP, namun tidak terdapat korelasi kadar likopen serum dengan VEP1/Prediksi dan KVP/Prediksi.

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Chronic Obstructive Pulmonary Disease COPD is a disease with decreasing pulmonary function, involving oxidative stres on its pathogenesis. Lycopene is one of the main carotenoids in lungs, with very potent antioxidant property. This cross sectional study was conducted at Persahabatan Hospital Jakarta, involving 47 subjects, aiming to investigate the correlation between serum lycopene level and lung function in COPD subjects. Interview was used to assess subjects rsquo characteristics and lycopene intake using semi quantitative food frequency questionnaire FFQ . COPD grouping was gathered from medical records or interview. Body mass index BMI was used to determine nutritional status, lung function test conducted by spirometry, while lycopene serum level was assessed using High Performance Liquid Chromatography HPLC method. All subjects were male, majority ge 60 years old, almost half ex heavy smokers, about 51 were in normal nutritional status. Lycopene intake was 4,407 256 ndash 18,331 mg day, lower compared to healthy subjects rsquo . Serum lycopene level was 0.57 0.25mmol L, similar to normal level in healthy individuals. There was a correlation p 0.001 r 0.464 between serum lycopene level and FEV1 FVC, but no correlations between serum lycopene level and FEV1 , neither was FVC . "

"Penyakit paru obstruktif kronik dapat menyebabkan seseorang mengalami keluhan pernapasan seperti sesak napas, batuk, sputum berlebih. Keluhan pernapasan dan berbagai faktor dapat mempengaruhi kualitas tidur. Penelitian ini bertujuan untuk mengetahui gambaran kualitas tidur pada pasien PPOK. Desain penelitian menggunakan cross sectional dengan purposive sampling. Sebanyak 200 sampel diambil di tiga rumah sakit daerah jakarta pada Mei-Juni 2018. Kuesioner menggunakan COPD Assesment Test dan Pittsburgh Sleep Quality Index. Hasil penelitan menunjukkan 66 pasien PPOK memiliki kualitas tidur buruk dengan masalah tertinggi yaitu durasi tidur. Kualitas tidur buruk ditemukan rata-rata pada usia 62 tahun, berjenis kelamin laki-laki, tingkat pendidikan SD/SMP, pendapatan kurang lebih Rp.2.000.000, menikah, IMT normal, memiliki >1 penyakit penyerta, terdiagnosis PPOK 12 bulan. Pasien PPOK yang mengalami kualitas tidur buruk mayoritas memiliki keluhan pernapasan sedang-berat. Tingkat keluhan pernapasan memiliki hubungan dengan kualitas tidur p = 0,016;OR:2,28. Perawat sebagai pemberi asuhan keperawatan diharapkan dapat memperbaiki atau meningkatkan kualitas tidur pasien PPOK.

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Chronic obstructive pulmonary disease can cause someone experience respiratory complaints such as shortness breath, coughing, excessive sputum. Respiratory complaints and many factors can influence sleep quality. This study purpose to describe sleep quality in COPD. Design used cross sectional purposive sampling in May June 2018. Respondents was 200 at three hospitals in Jakarta. Questionnaire used COPD Assesment Test and the PSQI.

Results showed that 66 COPD had poor sleep quality, the highest problems was sleep duration. Poor sleep quality was found average at 62 years old, male, education level in elementary junior high school, income Rp.2.000.000, married, had normal BMI and 1 comorbidities, diagnosed COPD for 12 months. Most of COPD who experience poor sleep had moderate severe respiratory complaints. There was relationship between respiratory complaints and poor sleep quality in COPD p 0.016 OR 2,28 . Nurses as caregivers is expected to correct or improve sleep quality in COPD."