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"ABSTRAKLatar belakang : Tuberkulosis (TB) menempati urutan pertama sebagai penyebab pertama kematian akibat infeksi di Indonesia. Angka kesakitan TB di Indonesia semakin bertambah dengan semakin banyaknya kasus multi drugresistant(MDR) TB. Pemeriksaan foto toraks merupakan bagian penegakkan diagnosis TB paru, terutama untuk menegakkan diagnosis MDR TB pada saat awal kunjungan penderita TB. Sampai saat ini belum ada data di Indonesiamengenai perbandingan karakteristik lesi foto toraks MDR TB dengan lesi foto toraks drug sensitive (DS) TB.Tujuan : Penelitian ini bertujuan untuk mengetahui perbandingan gambaran karakteristik lesi foto toraks MDR TB dengan lesi foto toraks DS TB. Bahan dan cara kerja : Penelitan ini dilakukan dengan studi retrospektifmenggunakan data sekundefr dari rekam medic penderita yang berobat ke poliklinik paru RS Persahabatan Jakarta selama periode Januari 2013 sampai Desember 2015. Pembacaan ulang foto toraks kunjungan pertama dalam semuarekam medik pasien MDR TB dan DS TB, dilakukan di bagian radiologi RSUP Persahabatan dan dibaca oleh spesialis radiologi konsultan toraks. Penilaian foto toraks meliputi morfologi, lokasi dan derajat lesi.Hasil : Gambaran foto toraks 183 penderita MDR TB dan 183 penderita DS TB memiliki lesi terbanyak berupa konsolidasi (57,4% vs 20,8%), kavitas (57,9% vs 6%), infiltrat (36,6% vs 66,7%). Kedua kelompok memiliki lesi terbanyak dilapangan atas paru kanan. Gambaran lesi bronkiektasis ditemukan terbanyak diMDR TB yaitu : 13,7% di lapangan tengah paru kanan. Kemlompok MDR TB memiliki kecenderungan derajat lesi luas lebih dominan dibandingkan DS TB(69% vs 27%).Kesimpulan : Dari penelitian ini didapatkan kesimpulan bahwa lesi konsolidasi multiple dan kavitas multiple multiple lebih dominan pada MDR TB dibandingkan DS TB dan gambaran bronkiektasis unilobuler hanya ditemui padaMDR TB terutama di lapangan tengah paru kanan. MDR TB memiliki derajat lesi luas dibandingkan dengan DS TB

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ABSTRACT

Background: Tuberculosis (TB) is still rhe first cause of death due to infection in Indonesia. TB morbidity rate in Indonesia will had increasing with more cases of multi-drug resistant (MDR) TB. Chest x-ray is part of the diagnosis tools of establishing pulmonary TB, particularly for diagnosis of MDR TB at the early

visit of TB patients. Until now there is no data especially in Indonesia regarding the comparison between chest x-ray lesion characteristics of MDR lung TB with

chest x-ray lesions of drug-sensitive (DS) lung TB.

Objective: The aims of this study to compare between lesions characteristic on chest x fray of MDR lung TB and lesions characteristicon chest x ray.of DS lung TB.

Materials and methods: This research was conducted a retrospective study using seconday data from patients medical records medic in pulmonology department in

Persahabatan Hospital Jakarta within period January 2013 to December 2015. Chest x-ray of the first admission of new cases of MDR lung TB and DS lung TB DS, were reviewed by thorax radiology specialist consultant carried out in

radiology department of Persahabatan hospital. Assesment of chest x-ray include morphology, lesion location and degree of the lesions.

Results: The comparison between chest x-ray lesions of 183 patiens with MDR TB and of chest x-ray lesions 183 patiens with DS TB of predominantly as multilobular consolidation (57.4% vs 20.8%), the multilobuler multiple cavity (57.9% vs 6%), multilobular infiltrates (36.6% vs 66,7%). Both groups had preferable location on the upper of the right lung. Bronchiectasis lesions had found most in MDR lung TB are : 13.7% mainly located in the middle of the right lung. MDR TB has a tendency estensive lesions was more dominant than the DS TB (69% vs 27%).

Conclusion. the multiple consolidation and multiple cavity were more dominant in MDR lung TB compared to DS lung TB and unilobuler bronchiectasis lesion only found on MDR lung TB, especially in middle of the right lung. MDR TB on chest x-ray have extensive lesions more dominant than DS TB."

"Latar Belakang : Berdasarkan onset gejala, efek jangka panjang dari pascaCOVID-19 disebut long COVID. Long COVID berlangsung dari pekan keempat sampai lebih dari dua belas pekan paascaonset gejala. Selain gejala sisa COVID-19, hal yang harus dievaluasi adalah gambaran lesi paru sebagai sekuele pascaCOVID-19. Sekuele paru pascaCOVID-19 dievaluasi dengan high resolution computed tomography (HRCT). Sekuele paru pascaCOVID-19 yang dapat timbul adalah ground glass opacity dan gambaran fibrosis. Selain derajat berat COVID-19, banyak faktor yang memengaruhi terjadinya sekuele paru pascaCOVID-19. Penelitian ini bertujuan untuk mengetahui seberapa besar kekerapan terjadinya sekuele paru pascaCOVID-19 dan faktor-faktor yang memengaruhinya. Metode : Penelitian ini merupakan penelitian observasional analitik dengan pendekatan kohort yang dilakukan bulan Juni 2020 hingga Juli 2021. Subjek penelitian adalah pasien pascaCOVID-19 yang melakukan HRCT toraks pada pekan keempat hingga keduabelas dari onset gejala dengan hasil PCR usap tenggorok minimal satu kali negatif. Subjek penelitian dipilih sesuai kriteria inklusi dan eksklusi. Pengambilan data melalui data sekunder berupa data rekam medis dan hasil HRCT pasien yang kontrol di poli pascaCOVID RSUP Persabahatan. Hasil: Pada penelitian ini didapatkan total 81 subjek dengan pasien yang memiliki sekuele pascaCOVID-19 ada sebanyak 64 pasien dan yang tidak mengalami sekuele sebanyak 17 orang. Kelompok pasien yang mengalami sekuele paru pascaCOVID-19 paling banyak ada pada kelompok 40-59 tahun sebanyak 34 dari 41 pasien. Pada penelitian ini pasien laki-laki memiliki hubungan dengan terjadinya sekuele pascaCOVID-19 (p=0,002). Komorbid paling banyak dijumpai pada penelitian ini adalah hipertensi (54,3) dan DM tipe II (23,4%). Derajat COVID-19 berat kritis berhubungan terhadap terjadinya sekuele paru pascaCOVID-19 (nilai p 0,003). Kejadian ARDS juga memiliki hubungan dengan terjadinya sekuele paru pascaCOVID-19 (p=0,007). Pemakaian oksigen (O2) meliputi fraksi (p= 0,005) dan durasi (p= 0,006) juga memiliki hubungan yang bermakna dengan terjadinya sekuele paru pascaCOVID-19. Hasil analisis multivariat mendapatkan jenis kelamin dan derajat berat merupakan faktor-faktor yang memengaruhi sekuele paru pasca-COVID-19.

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Background: The long-term effects of post-COVID-19 are known as long COVID based on the onset of symptoms. Long COVID lasts from the fourth week to more than twelve weeks after the onset of symptoms. In addition to the sequelae of COVID-19, what must be evaluated is the appearance of lung lesions as a sequelae after COVID-19. Post-COVID19 pulmonay sequelae was evaluated by high-resolution computed tomography (HRCT) as ground glass opacity and fibrosis. Beside COVID-19 severity, a variety of other factors have a role in the development of post-COVID-19 pulmonary sequelae. The purpose of this study is to determine the frequency of post-COVID-19 pulmonary sequelae and their influencing factors.

Methods: This study was an analytic observational study with a cohort approach that was conducted from June 2020 to July 2021. The subjects were post-COVID-19 patients who underwent thoracic HRCT in the fourth to twelfth week of symptom onset with a negative throat swab PCR result at least once. The inclusion and exclusion criteria were used to determine which subjects will be included in the study. Data collection through secondary data form medical record and HRCT results of patients controlled at the post-COVID polyclinic at Persahabatan Hospital.

Results: In this study, there were 64 patients who had post-COVID-19 sequelae and 17 patients who did not. There was a total of 81 subjects. The group of patients who experienced post-COVID-19 pulmonary sequelae was mostly in the 40-59 years group with 34 out of 41 patients. In this study, male patients had an association with post-COVID-19 sequelae (p=0.002). The most common comorbidities found in this study were hypertension (54.3) and type II DM (23.4%). The degree of critically severe COVID-19 is related to the occurrence of post-COVID-19 pulmonary sequelae (p 0.003). The incidence of ARDS also has a relationship with the occurrence of post-COVID-19 pulmonary sequelae (p=0.007). Oxygen consumption including fraction of inspired oxygen (p= 0.005) and duration (p= 0.006) also has a significant relationship with the occurrence of post-COVID-19 pulmonary sequelae. The results of the multivariate analysis found that gender and severity were factors that influenced post-COVID-19 pulmonary sequelae."

"Pemeriksaan HRCT toraks mengevaluasi secara objektif perubahan pada gambaran parenkim paru akibat respons inflamasi termasuk pada pasien pasca COVID-19. Riwayat terapi selama pasien dirawatinapkan merupakan faktor yang diduga berpengaruh terhadap gambaran HRCT toraks pasca COVID-19. Penelitian ini menganalisis hubungan antara riwayat terapi tersebut dengan gambaran HRCT toraks dengan subjek yang diperiksakan antara Juni 2020-Juli 2021. Metode yang digunakan adalah observasional analitik dengan pendekatan kohort pada data sekunder melalui telusur rekam medis. Pada 73 subjek penelitian dilakukan analisis univariat, bivariat (uji kai kuadrat dan fisher) dan multivariat (uji regresi logistik) dengan variabel independen terdiri atas karakteristik individu (usia, jenis kelamin, komorbiditas, derajat COVID-19) dan riwayat terapi (antivirus, antiinflamasi dan antitrombotik) serta variabel dependen berupa gambaran HRCT toraks. Terdapat gambaran sekuele sebanyak 55 subjek (75,3%) dengan rincian 7 subjek (9,6%) dengan gambaran fibrosis, 5 subjek (6,8%) dengan gambaran GGO, 43 subjek (59,9%) dengan gambaran GGO dan fibrosis serta gambaran nonsekuele sebanyak 18 subjek (24,7%). Gambaran sekuele terhadap variabel masing-masing adalah sebagai berikut: laki-laki dan perempuan yaitu 78,8% dan 66,7% (p=0,025, OR= 0,019-0,770), derajat ringan, sedang dan berat-kritis yaitu 56,5%, 75,0% dan 88,2% (p=0,031-1,096-6,962), subjek dengan dan tanpa warfarin yaitu 57,1% dan 82,7% (p=0,007, OR=0,016-0,517), subjek dengan dan tanpa heparin yaitu 83,3% dan 60,0% (p=0,024, OR= 1,250-23,222), subjek dengan durasi terapi antiinflamasi ≤10 hari dan >10 hari yaitu 61,0% dan 93,5% (p=0,026, OR=1,276-42,609). Laki-laki-laki lebih banyak memiliki gambaran sekuele pasca COVID-19 pada HRCT toraks daripada perempuan. Derajat COVID-19 adalah faktor paling berpengaruh dan menentukan pemilihan terapi rawat inap. Kelompok subjek dengan warfarin memiliki gambaran sekuele pasca COVID-19 pada HRCT toraks lebih banyak daripada tanpa warfarin. Kelompok subjek dengan heparin memiliki gambaran sekuele pasca COVID-19 pada HRCT toraks lebih banyak daripada tanpa heparin. Kelompok subjek dengan durasi terapi antiinflamasi ≤10 hari memiliki gambaran sekuele pasca COVID-19 pada HRCT toraks lebih sedikit daripada dengan terapi antiinflamasi >10 hari.

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Chest HRCT is an objective examination to evaluate alteration in lung parenchyma due to inflammation response including in post COVID-19 patients. Inward patient therapy history is one of factor to be suspected has an influence to chest HRCT features in post COVID-19 patients. This study analyzes a relation between therapy history and chest HRCT features was examined between June 2020 and June 2021. Observational analytic with retrospective approach method is used by medical record explore as secondary data. In 73 subjects in this study, univariate analysis, bivariate analysis (chi square and fisher’s test), and multivariate analysis (logistic regression) had done to perform the description of independent variable consists individual characteristics (age, sex, comorbidity, COVID-19 severity degree) and therapy history (antiviral, antiinflammation, antithrombotic), and chest HRCT features as dependent variable. There are sequelae features in 55 subjects (75.3%) consist of 7 subjects (9.6%) with fibrotic features, 5 subjects (6.8%) with GGO and 43 subjects (59.9%) and also 18 subjects (24.7%) non-sequelae features. Sequelae features for each variable are: male and female are 78,8% vs 66,7% (p=0.025, OR= 0.019-0.770), mild, moderate, and severe-critical COVID-19 severity degree are 56,5% vs 75,0% vs 88,2% (p=0,031-1,096-6,962), subjects with and without warfarin are 57,1% vs 82,7% (p=0,007, OR=0,016-0,517), subjects with and without heparin are 83,3% vs 60,0% (p=0,024, OR= 1,250-23,222), subject with antiinflammation therapy duration ≤10 days is higher risk than >10 days are 61,0% vs 93,5% (p=0,026, OR=1,276-42,609). Males are larger number with post COVID-19 sequelae features in chest HRCT than females. The severity degree of COVID-19 is the most influencing factor and this determines on inpatient therapy selection. Warfarin history subjects are smaller number with post COVID-19 sequelae features in chest HRCT than in without warfarin. Heparin history subjects are larger number with post COVID-19 sequelae features in chest HRCT than in without heparin. Anti-inflammatory therapy duration ≤10 days are smaller number with post COVID-19 sequelae features in chest HRCT than in > 10 days."

"Latar Belakang: Penelitian ini merupakan studi awal untuk menetapkan proporsi pneumonitis radiasi pada pasien kanker paru yang mendapat radiasi di RSUP Persahabatan. Metode: Penelitian ini menggunakan desain retrospektif pada pasien kanker paru yang mendapat radiasi di RSUP Persahabatan antara Juni 2013-Juli 2015. Pengambilan data melalui rekam medik dan dilakukan evaluasi ulang foto toraks 1 bulan pasca radiasi. Hasil: Terdapat 33 pasien kanker paru yang memenuhi kriteria inklusi. Karakteristik subyek meliputi usia ≥51 tahun (63,6%), laki-laki (66,7%), riwayat merokok (75,8%), IB sedang (60%), dosis radiasi 300-4000 (60,6%), fraksi radiasi 10-19 (60,6%), tidak mempunyai riwayat kemoterapi (54,5%), kanker paru jenis adenokarsinoma (66,7%) dan stage IV (84,84%). Proporsi pneumonitis radiasi berdasarkan foto toraks sebesar 39,4% yang terdiri dari gambaran hazy ground glass opacities, hazy ground glass opacities dan fibrosis serta fibrosis. Ditemukan perbedaan bermakna antara usia, dosis radiasi dan riwayat kemoterapi dengan kejadian pneumonitis radiasi (p<0,05). Kesimpulan: Proporsi pneumonitis radiasi berdasarkan foto toraks sebesar 39,4%. Terdapat perbedaan bermakna antara usia, dosis radiasi dan riwayat kemoterapi dengan kejadian pneumonitis radiasi.

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Introduction: This is a preliminary study to determine proportion radiation pneumonitis in lung cancer patients who got radiaton in Persahabatan Hospital.

Method: This was a retrospective study in lung cancer patients who got radiation in Persahabatan Hospital between June 2013 ? July 2015. Interpretation data were from medical record and did reevaluation chest x ray 1 month after radiation.

Result: There were 33 lung cancer patients were filled inclusion criteria. Subjects characteristic were age ≥51 years (63,6%), male (66,7%), history of smoking (75,8%), moderate IB (60%), radiation doses 3000-4000 (60,6%), radiation fractions 10-19 (60,6%), had no history of chemotheraphy (54,5%), adenocarcinoma (66,7%) and stage IV (84,84%). Proportion radiation pneumonitis based on chest x ray were 39,4% that include hazy ground glass opacities, hazy ground glass opacitiesand fibrosis and only fibrosis. There were significant differences between age, radiation doses and history of chemotheraphy with proportion radiation pneumonitis (p<0,05).

Conclusion: Proportion radiation pneumonitis based on chest x ray are 39,4%. There are significant differences between age, radiation doses and history of chemotheraphy with proportion radiation pneumonitis (p<0,05)."