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Short-term outcomes following congenital heart surgery in children with Down syndrome 唐氏综合征患儿先天性心脏手术后的短期疗效
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-06-29 DOI: 10.14238/pi63.3.2023.181-8
Tri Yanti Rahayuningsih, S. Putra, P. B. Yanuarso, Zulham Effendy
Background Children with Down syndrome (DS) differ from typical children because of many genetic-related aspects that may affect outcomes after congenital heart surgery. To date, there have been no studies on outcomes after congenital heart surgery on pediatric DS patients in Indonesia. Objective To determine outcomes and mortality in DS patients who underwent heart surgery at Dr. Cipto Mangunkusumo Hospital, Jakarta. Methods A prospective and retrospective cohort study was conducted in DS patients aged <15 years who underwent heart surgery from July 2007 to April 2015. The control group were patients in the same age range without DS who underwent heart surgery for various types of heart defects. Results  There were 57 DS and 43 non-DS patients during study period. The types of heart defects found in DS patients were atrioventricular septal defect (AVSD) and ventricular septal defect (VSD) in 18/57 (31.6%) patients each, tetralogy of Fallot (12/57; 21%), atrial septal defect (ASD) (4/57; 7%), patent ductus arteriosus (PDA) (4/57; 7%) and transposition of the great arteries with VSD (TGA-VSD) (1/57; 1.8%). DS patients showed an increased incidence of preoperative PH (63.1%)  compared to non-DS patients (25.6%). Median duration of surgery was longer in DS [2.9 (range 0.5-5.8) hours] than in non-DS [2.2 (range 0.7-4.7) hours]. DS patients have a longer mean cardiopulmonary bypass duration [79.5 (SD 33.9) minutes] compared to non-DS [59.9 (SD 23.6) minutes], longer mean aortic cross-clamp duration [45.3 (SD 23.7) minutes] compared to non-DS [34.8 (SD 15.7)]. There were significant differences in the incidence of preoperative pulmonary hypertension, surgical time, duration of cardiopulmonary bypass (CPB), and length of the aortic cross-clamp in DS patients compared to non-DS (P<0.05). Median length of ICU stay was 1.9 (range 0.6 to 34) days in DS and 1 (range 0.3 to 43) day in non-DS patients (P=0.373). Median duration of mechanical ventilation [19.9 (range 3-540) vs. 8 (range 3-600) hours (P=0.308)], rate of pulmonary complications [14/57 (24.6%) vs. 6/43 (14%) patients (P=0.216)], and incidence of sepsis [16/57 (28.1%) vs. 6/43 (14%) patients (P=0.143)] were not significantly different between DS and non-DS patients. However, complete atrioventricular (AV) block only occurred in DS patients [6/57 (10.5%)]. In the DS group, 5/57 (8.8%) patients died. There was no mortality in the non-DS group. Conclusion  Morbidity and mortality after cardiac surgery in were higher in DS than in non-DS patients. DS patients may have problems related to preoperative PH, AV block, longer surgical time, duration of CPB, and aortic cross-clamp compared to non-DS.
唐氏综合症(DS)儿童不同于典型儿童,因为许多与遗传相关的方面可能会影响先天性心脏手术后的结果。迄今为止,还没有关于印度尼西亚儿童退行性椎体滑移患者先天性心脏手术后结果的研究。目的探讨雅加达Dr. Cipto Mangunkusumo医院接受心脏手术的DS患者的预后和死亡率。方法对2007年7月至2015年4月接受心脏手术的年龄<15岁的DS患者进行前瞻性和回顾性队列研究。对照组为同年龄段无退行性退行各种心脏缺陷手术的患者。结果研究期间发生退行性椎体滑移57例,非退行性椎体滑移43例。DS患者的心脏缺损类型为房室间隔缺损(AVSD)和室间隔缺损(VSD),各占18/57(31.6%),法洛四联症(12/57);21%),房间隔缺损(ASD) (4/57;7%),动脉导管未闭(PDA) (4/57;7%)和大动脉转位合并VSD (TGA-VSD) (1/57;1.8%)。与非DS患者(25.6%)相比,DS患者术前PH发生率增加(63.1%)。DS组的中位手术时间[2.9(0.5-5.8)小时]比非DS组的中位手术时间[2.2(0.7-4.7)小时]更长。DS患者的平均体外循环时间[79.5 (SD 33.9)分钟]比非DS患者[59.9 (SD 23.6)分钟]更长,平均主动脉交叉夹持时间[45.3 (SD 23.7)分钟]比非DS患者[34.8 (SD 15.7)]更长。DS组与非DS组在术前肺动脉高压发生率、手术时间、体外循环时间、主动脉交叉夹长度等方面差异均有统计学意义(P<0.05)。DS患者在ICU的中位住院时间为1.9天(0.6 ~ 34天),非DS患者为1天(0.3 ~ 43天)(P=0.373)。机械通气的中位持续时间[19.9(范围3-540)比8(范围3-600)小时(P=0.308)]、肺部并发症发生率[14/57(24.6%)比6/43(14%)患者(P=0.216)]、败血症发生率[16/57(28.1%)比6/43(14%)患者(P=0.143)]在退行性椎体滑移患者和非退行性椎体滑移患者之间无显著差异。然而,完全房室传导阻滞仅发生在DS患者中[6/57(10.5%)]。DS组有5/57(8.8%)患者死亡。非ds组无死亡率。结论退行性心动过速患者心脏手术后的发病率和死亡率高于非退行性心动过速患者。与非DS患者相比,DS患者可能存在术前PH、房室阻滞、较长的手术时间、CPB持续时间和主动脉交叉夹等问题。
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引用次数: 0
The association between premature rupture of membranes (PROM) and preterm gestational age with neonatal sepsis: a systematic review and meta-analysis 胎膜早破(PROM)和早产胎龄与新生儿脓毒症之间的关系:一项系统回顾和荟萃分析
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-06-28 DOI: 10.14238/pi63.3.2023.152-61
Nanda Andini, Lili Rohmawati, E. Fikri, Bugis Mardina
Background Sepsis is one of the main causes of neonatal mortality. The morbidity and mortality rates due to neonatal sepsis are as high as 9-20%. Premature rupture of membranes (PROM) and preterm gestational age are among the risk factors of neonatal sepsis. Objective To evaluate for potential associations between PROM as well as preterm gestational age to neonatal sepsis by meta-analysis and systematic review. Methods A meta-analysis and systematic review were performed using literature sourced from PubMed, Cochrane, and Google Scholar according to PRISMA guidelines. We calculated the incidence of sepsis in neonates with and without PROM and premature gestational age. Journal quality was assessed according to the Newcastle-Ottawa Scale (NOS) criteria. Results From the literature search for PROM, 21 case-control studies met the inclusion criteria. Neonatal sepsis was more common in neonates who had a maternal history of PROM than in those without [OR 2.69 (95%CI 1.56 to 4.65); P<0.00001]. From the literature search for gestational age, we found 17 case-control studies that met the inclusion criteria. Neonatal sepsis was more common in preterm than term neonates [OR 2.55 (95%CI 1.61 to 4.04); P<0.00001]. Conclusion Neonates with a maternal history of PROM and/or preterm gestational age are at high risk of developing neonatal sepsis.
脓毒症是新生儿死亡的主要原因之一。新生儿败血症的发病率和死亡率高达9-20%。胎膜早破(PROM)和胎龄过早是新生儿败血症的危险因素。目的通过荟萃分析和系统评价,探讨胎膜早破和早产胎龄与新生儿脓毒症的潜在关系。方法根据PRISMA指南,使用PubMed、Cochrane和Google Scholar的文献进行meta分析和系统评价。我们计算了脓毒症在有和没有胎早破和早产的新生儿中的发生率。期刊质量根据纽卡斯尔-渥太华量表(NOS)标准进行评估。结果从文献检索中,有21例病例对照研究符合纳入标准。新生儿脓毒症在母亲有胎膜早破史的新生儿中比无胎膜早破史的新生儿更常见[OR 2.69 (95%CI 1.56 ~ 4.65);P < 0.00001)。通过对胎龄的文献检索,我们发现了17项符合纳入标准的病例对照研究。新生儿脓毒症在早产儿中比足月新生儿更常见[OR 2.55 (95%CI 1.61 ~ 4.04);P < 0.00001)。结论母亲有胎膜早破史和/或早产胎龄的新生儿发生新生儿脓毒症的风险较高。
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引用次数: 1
Resurgence of measles infection among children: findings from a surveillance-based population study 儿童麻疹感染死灰复燃:基于监测的人口研究结果
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-06-28 DOI: 10.14238/pi63.3.2023.162-8
Na’eemah Zaini, Idayu Badilla Idris, Intan Azura Mhd. Din, Norfazilah Ahmad
Background There has been a resurgence of measles infection in countries with high vaccination rates, including Malaysia. Understanding the geographical variation in measles resurgence and associated factors is important for measles prevention and control programs, especially where local information is scarce. Objective To determine the incidence of laboratory-confirmed measles infection and associated factors in the state of Melaka, in the southern region of Malaysia. Methods We obtained measles surveillance data for 4 years (January 2015 to December 2018) from the e-Measles national database. A comparative cross-sectional study was carried out on these data involving children who had been selected through convenience sampling. Results A total of 130 laboratory-confirmed measles cases and 213 non-measles cases were included in the study. Among the laboratory-confirmed cases, 56 (43.1%) had not been vaccinated against measles virus. Thirty-eight cases (51.4%) had received at least one dose of measles vaccine, while 36 cases (48.6%) had completed two doses of measles vaccination. There was a higher risk of contracting laboratory-confirmed measles among unvaccinated children (OR 19.39, 95%CI 8.82 to 42.6, P<0.001) and children aged 8–18 years (OR 0.40, 95% CI 0.21 to 0.76, P=0.005) Conclusion Unvaccinated children and children aged 8–18 years have a higher risk of contracting laboratory-confirmed measles. The policy on routine immunization should be strengthened, the vaccine should be accessible to all children, and all children and adolescents should be given booster vaccinations.
背景在疫苗接种率高的国家,包括马来西亚,麻疹感染再次出现。了解麻疹复发的地理差异及其相关因素对麻疹预防和控制规划非常重要,特别是在当地信息匮乏的情况下。目的了解马来西亚南部地区马六甲州实验室确诊麻疹感染的发病率及相关因素。方法从e-麻疹国家数据库获取2015年1月至2018年12月4年麻疹监测数据。对这些数据进行了比较横断面研究,涉及通过方便抽样选择的儿童。结果共纳入实验室确诊麻疹病例130例,非麻疹病例213例。在实验室确诊病例中,56例(43.1%)未接种麻疹病毒疫苗。38例(51.4%)至少接种了一剂麻疹疫苗,36例(48.6%)完成了两剂麻疹疫苗接种。未接种麻疹疫苗的儿童(OR为19.39,95%CI为8.82 ~ 42.6,P<0.001)和8 ~ 18岁儿童(OR为0.40,95%CI为0.21 ~ 0.76,P=0.005)感染实验室确诊麻疹的风险较高。应加强常规免疫政策,使所有儿童都能获得疫苗,并对所有儿童和青少年进行加强疫苗接种。
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引用次数: 0
Effects of lung recruitment maneuvers using mechanical ventilator on preterm hemodynamics 机械呼吸机肺补充操作对早产儿血流动力学的影响
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-06-28 DOI: 10.14238/pi63.3.2023.173-80
Adhi Teguh Perma Iskandar, Ahmad Kautsar, A. Rahmadhany, Risma K Kaban, B. Supriyatno, J. Prihartono, D. I. Santoso, Tetty Yuniarti, N. Advani, M. M. Djer, Fiolita I. Sutjipto
Background Lung recruitment maneuvers (LRMs) are a strategy to gradually increase mean positive airway pressure (MAP) to expand the alveoli, leading to decreased pulmonary vascular resistance and increased cardiac output (CO). However, the hemodynamic impact of LRM using assist control volume guarantee (AC-VG) ventilator mode done in preterm infants born at 24 to 32 weeks’ gestation, especially in the first 72 hours of life, remains unknown. Objective To determine the effect of LRM on right- and left cardiac ventricular output (RVO and LVO), ductus arteriosus (DA) diameter and its pulmonary hypertension (PH) flow pattern, as well as superior mesenteric artery (SMA) flow. Method This randomized, controlled, single-blinded clinical trial was performed in 24-32-week preterm neonates with birth weights of >600 grams. Subjects were allocated by block randomization to the LRM and control groups, each containing 55 subjects. We measured RVO, LVO, DA diameter, PH flow pattern, and SMA resistive index (RI) at 1 and 72 hours after mechanical ventilation was applied. We analyzed for hemodynamic differences between the two groups. Results During the initial 72 hours of mechanical ventilation, there were no significant differences between the control vs. LRM groups in mean changes of LVO [41.40 (SD 91.21) vs. 15.65 (SD 82.39) mL/kg/min, respectively; (P=0.138)] or mean changes of RVO [65.56 (SD 151.20) vs. 70.59 (SD 133.95) mL/kg/min, respectively; (P=0.859)]. Median DA diameter reduction was -0.08 [interquartile range (IQR) -0.55; 0.14] mm in the  control group and -0.10 (IQR -0.17 to -0.01) mm in the LRM group (P=0.481). Median SMA resistive index was 0.02 (IQR -0.16 to 0.24) vs. 0.01(IQR -0.20 to 0.10) in the control vs. LRM group, respectively. There was no difference in proportion of pulmonary hypertension flow pattern at 72 hours (25.4% vs. 20% in the control vs. LRM group, respectively) (P=0.495). Conclusion When preterm infants of 24-32 weeks gestational age are placed on mechanical ventilation, LRM gives neither additional hemodynamic benefit nor harm compared to standard ventilator settings.
肺复吸演习(lrm)是一种逐渐增加平均气道正压(MAP)以扩大肺泡,导致肺血管阻力降低和心输出量(CO)增加的策略。然而,使用辅助控制容积保证(AC-VG)呼吸机模式的LRM对妊娠24 ~ 32周出生的早产儿,特别是生命最初72小时的血液动力学影响尚不清楚。目的探讨LRM对左、右心室输出量(RVO和LVO)、动脉导管(DA)直径及其肺动脉高压(PH)血流模式以及肠系膜上动脉(SMA)血流的影响。方法采用随机、对照、单盲临床试验对出生体重>600 g的24 ~ 32周早产儿进行研究。受试者采用分组随机法分为LRM组和对照组,每组55名受试者。我们在机械通气后1和72小时测量RVO、LVO、DA直径、PH流型和SMA电阻指数(RI)。我们分析两组之间的血流动力学差异。结果在机械通气的最初72小时,对照组与LRM组LVO的平均变化无显著差异[分别为41.40 (SD 91.21)和15.65 (SD 82.39) mL/kg/min;(P=0.138)]或RVO的平均变化[分别为65.56 (SD 151.20)和70.59 (SD 133.95) mL/kg/min;(P = 0.859)。中位DA直径减小为-0.08[四分位间距(IQR) -0.55;对照组为0.14]mm, LRM组为-0.10 (IQR为-0.17 ~ -0.01)mm (P=0.481)。对照组和LRM组的SMA电阻指数中位数分别为0.02 (IQR -0.16至0.24)和0.01(IQR -0.20至0.10)。72小时肺动脉高压血流模式比例无差异(对照组和LRM组分别为25.4%和20%)(P=0.495)。结论:当24-32周胎龄的早产儿使用机械通气时,与标准呼吸机设置相比,LRM既没有额外的血流动力学益处,也没有伤害。
{"title":"Effects of lung recruitment maneuvers using mechanical ventilator on preterm hemodynamics","authors":"Adhi Teguh Perma Iskandar, Ahmad Kautsar, A. Rahmadhany, Risma K Kaban, B. Supriyatno, J. Prihartono, D. I. Santoso, Tetty Yuniarti, N. Advani, M. M. Djer, Fiolita I. Sutjipto","doi":"10.14238/pi63.3.2023.173-80","DOIUrl":"https://doi.org/10.14238/pi63.3.2023.173-80","url":null,"abstract":"Background Lung recruitment maneuvers (LRMs) are a strategy to gradually increase mean positive airway pressure (MAP) to expand the alveoli, leading to decreased pulmonary vascular resistance and increased cardiac output (CO). However, the hemodynamic impact of LRM using assist control volume guarantee (AC-VG) ventilator mode done in preterm infants born at 24 to 32 weeks’ gestation, especially in the first 72 hours of life, remains unknown. \u0000Objective To determine the effect of LRM on right- and left cardiac ventricular output (RVO and LVO), ductus arteriosus (DA) diameter and its pulmonary hypertension (PH) flow pattern, as well as superior mesenteric artery (SMA) flow. \u0000Method This randomized, controlled, single-blinded clinical trial was performed in 24-32-week preterm neonates with birth weights of >600 grams. Subjects were allocated by block randomization to the LRM and control groups, each containing 55 subjects. We measured RVO, LVO, DA diameter, PH flow pattern, and SMA resistive index (RI) at 1 and 72 hours after mechanical ventilation was applied. We analyzed for hemodynamic differences between the two groups. \u0000Results During the initial 72 hours of mechanical ventilation, there were no significant differences between the control vs. LRM groups in mean changes of LVO [41.40 (SD 91.21) vs. 15.65 (SD 82.39) mL/kg/min, respectively; (P=0.138)] or mean changes of RVO [65.56 (SD 151.20) vs. 70.59 (SD 133.95) mL/kg/min, respectively; (P=0.859)]. Median DA diameter reduction was -0.08 [interquartile range (IQR) -0.55; 0.14] mm in the  control group and -0.10 (IQR -0.17 to -0.01) mm in the LRM group (P=0.481). Median SMA resistive index was 0.02 (IQR -0.16 to 0.24) vs. 0.01(IQR -0.20 to 0.10) in the control vs. LRM group, respectively. There was no difference in proportion of pulmonary hypertension flow pattern at 72 hours (25.4% vs. 20% in the control vs. LRM group, respectively) (P=0.495). \u0000Conclusion When preterm infants of 24-32 weeks gestational age are placed on mechanical ventilation, LRM gives neither additional hemodynamic benefit nor harm compared to standard ventilator settings.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"11 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74882546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Serum transforming growth factor-beta levels and severity of retinoblastoma in children 儿童视网膜母细胞瘤的血清转化生长因子- β水平和严重程度
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-06-28 DOI: 10.14238/pi63.3.2023.169-72
Paediatrica Indonesiana, M. F. Huzein, Nadirah Rasyid, D. Daud, M. F. Huzein
Background Transforming growth factor-? (TGF-?) expression contributes to the growth of retinoblastoma. TGF-? is produced or released by infiltrating cells such as lymphocytes and monocytes/macrophages. TGF-? levels are a potential marker of disease severity. Objective To assess the difference in serum TGF-? levels before chemotherapy in patients with retinoblastoma grades III and IV.  Methods This cross-sectional observational study was done at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia from January to November 2019. Subjects were pediatric patients with grade III and IV retinoblastoma who had not undergone chemotherapy. Patients who met the inclusion criteria provided blood specimens for TGF-? testing. We analyzed the difference in serum TGF-? level between grade III and grade IV patients. Results We obtained 38 subjects, consisting of 13 grade III and 25 grade IV retinoblastoma patients. Mean TGF-? levels were in 1,061 ng/L in grade III and 988 ng/L in grade IV patients. The Mann-Whitney U test revealed no significant difference between the levels of TGF-?, retinoblastoma grade III and IV (P=0.655). However, TGF-? levels in both groups were markedly above the normal value (100 ng/L). Conclusion TGF-? levels are markedly increased in grade III and IV retinoblastoma patients. There was no significant difference in TGF-? level between grade III and IV patients. Our findings suggest that TGF-? plays an important role in tumor cell development. Further research on differences in TGF-? levels between late stages (grades III and IV) and early stages (grades I and II) of retinoblastoma to elucidate the role of TGF-? as a  marker of retinoblastoma severity.
转化生长因子-?(TGF-?)的表达促进了视网膜母细胞瘤的生长。TGF - ?由浸润细胞如淋巴细胞和单核/巨噬细胞产生或释放。TGF - ?水平是疾病严重程度的潜在标志。目的探讨血清TGF-?方法本横断面观察性研究于2019年1月至11月在印度尼西亚望加锡Wahidin Sudirohusodo医生医院进行。研究对象为未接受化疗的III级和IV级视网膜母细胞瘤患儿。符合纳入标准的患者提供血液标本检测TGF-?测试。我们分析了血清TGF-?在III级和IV级患者之间。结果38例受试者,包括13例III级和25例IV级视网膜母细胞瘤患者。TGF -意味着什么?III级患者的水平为1061 ng/L, IV级患者为988 ng/L。Mann-Whitney U检验显示TGF-?III级和IV级视网膜母细胞瘤(P=0.655)。然而,TGF - ?两组均明显高于正常值(100 ng/L)。结论TGF - ?III级和IV级视网膜母细胞瘤患者的水平明显升高。两组间TGF-?在III级和IV级患者之间。我们的研究结果表明TGF-?在肿瘤细胞发育中起重要作用。TGF-?差异的进一步研究在晚期(III级和IV级)和早期(I级和II级)视网膜母细胞瘤中TGF-?作为视网膜母细胞瘤严重程度的标志。
{"title":"Serum transforming growth factor-beta levels and severity of retinoblastoma in children","authors":"Paediatrica Indonesiana, M. F. Huzein, Nadirah Rasyid, D. Daud, M. F. Huzein","doi":"10.14238/pi63.3.2023.169-72","DOIUrl":"https://doi.org/10.14238/pi63.3.2023.169-72","url":null,"abstract":"Background Transforming growth factor-? (TGF-?) expression contributes to the growth of retinoblastoma. TGF-? is produced or released by infiltrating cells such as lymphocytes and monocytes/macrophages. TGF-? levels are a potential marker of disease severity. \u0000Objective To assess the difference in serum TGF-? levels before chemotherapy in patients with retinoblastoma grades III and IV.  \u0000Methods This cross-sectional observational study was done at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia from January to November 2019. Subjects were pediatric patients with grade III and IV retinoblastoma who had not undergone chemotherapy. Patients who met the inclusion criteria provided blood specimens for TGF-? testing. We analyzed the difference in serum TGF-? level between grade III and grade IV patients. \u0000Results We obtained 38 subjects, consisting of 13 grade III and 25 grade IV retinoblastoma patients. Mean TGF-? levels were in 1,061 ng/L in grade III and 988 ng/L in grade IV patients. The Mann-Whitney U test revealed no significant difference between the levels of TGF-?, retinoblastoma grade III and IV (P=0.655). However, TGF-? levels in both groups were markedly above the normal value (100 ng/L). \u0000Conclusion TGF-? levels are markedly increased in grade III and IV retinoblastoma patients. There was no significant difference in TGF-? level between grade III and IV patients. Our findings suggest that TGF-? plays an important role in tumor cell development. Further research on differences in TGF-? levels between late stages (grades III and IV) and early stages (grades I and II) of retinoblastoma to elucidate the role of TGF-? as a  marker of retinoblastoma severity.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"14 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81816542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differences in induction phase outcomes of acute lymphoblastic leukemia between well-nourished and malnourished pediatric patients 营养良好和营养不良儿童急性淋巴细胞白血病诱导期结局的差异
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-06-27 DOI: 10.14238/pi63.3.2023.146-51
Meilani Puspasari Simarmata, Nelly Rosdiana, A. Wahyuni
Background Leukemia is the most common malignancy in childhood. Malnutrition is the main nutritional disorder occurring in children with cancer. Nutritional supportive care is a medical modality that has been associated with improved tolerance to chemotherapy, survival, and quality of life, as well as decreased risk of infection in children undergoing cancer therapy. Objective To examine differences in induction phase outcomes in well-nourished and malnourished pediatric acute lymphoblastic leukemia (ALL) patients. Methods This prospective study was conducted in newly-diagnosed ALL patients aged 1 to 18 years who underwent induction phase chemotherapy at Haji Adam Malik General Hospital, Medan, North Sumatera. Mid-upper arm circumference (MUAC) was used to determine nutritional status. Patient characteristics such as complete blood count (CBC) at the time of diagnosis, occurrence of febrile neutropenia, duration of induction, length of hospital stay, and remission status were collected. We analyzed differences in CBC, frequency of febrile neutropenia, as well as duration of induction and hospital stay between well-nourished and malnourished patients. We also assessed the difference in remission attainment between the two groups. Results There were 21 subjects in each group. Compared to well-nourished subjects, malnourished ones had a higher median incidence of febrile neutropenia [1 (range 0 to 30) vs. 3 (range 0 to 4); P=0.04], longer mean induction duration [64.2 (SD 11.5) vs. 71.2 (SD 10.6) days; P=0.046], and longer median hospital stay [30 (range 19 to 56) vs. 36 (range 22 to 49) days; P=0.001] compared to well-nourished subjects. There was no significant difference in CBC parameters and remission status after induction between the two groups. Conclusion Malnourished pediatric ALL patients had a significantly higher incidence of febrile neutropenia, duration of induction phase, and duration of hospital stay compared to well-nourished ALL patients.
白血病是儿童时期最常见的恶性肿瘤。营养不良是癌症儿童的主要营养失调。营养支持治疗是一种医学模式,可以改善接受癌症治疗的儿童对化疗的耐受性、生存率和生活质量,并降低感染风险。目的探讨营养良好和营养不良儿童急性淋巴细胞白血病(ALL)患者诱导期结局的差异。方法前瞻性研究在北苏门答腊省棉兰市哈吉·亚当·马利克综合医院进行的1 ~ 18岁新诊断的ALL患者的诱导期化疗。采用中上臂围(MUAC)测定营养状况。收集患者特征,如诊断时全血细胞计数(CBC)、发热性中性粒细胞减少症的发生、诱导持续时间、住院时间和缓解状态。我们分析了营养良好和营养不良患者的CBC、发热性中性粒细胞减少的频率、诱导时间和住院时间的差异。我们还评估了两组间缓解程度的差异。结果每组21例。与营养良好的受试者相比,营养不良的患者发热性中性粒细胞减少症的中位发生率更高[1(范围0至30)vs. 3(范围0至4);P=0.04],平均诱导持续时间更长[64.2 (SD 11.5) vs. 71.2 (SD 10.6)天;P=0.046],中位住院时间更长[30天(19 ~ 56天)对36天(22 ~ 49天);P=0.001]与营养良好的受试者相比。两组患者诱导后CBC参数及缓解状态无显著差异。结论与营养良好的ALL患儿相比,营养不良患儿的发热性中性粒细胞减少症发生率、诱导期持续时间和住院时间均显著增加。
{"title":"Differences in induction phase outcomes of acute lymphoblastic leukemia between well-nourished and malnourished pediatric patients","authors":"Meilani Puspasari Simarmata, Nelly Rosdiana, A. Wahyuni","doi":"10.14238/pi63.3.2023.146-51","DOIUrl":"https://doi.org/10.14238/pi63.3.2023.146-51","url":null,"abstract":"Background Leukemia is the most common malignancy in childhood. Malnutrition is the main nutritional disorder occurring in children with cancer. Nutritional supportive care is a medical modality that has been associated with improved tolerance to chemotherapy, survival, and quality of life, as well as decreased risk of infection in children undergoing cancer therapy. \u0000Objective To examine differences in induction phase outcomes in well-nourished and malnourished pediatric acute lymphoblastic leukemia (ALL) patients. \u0000Methods This prospective study was conducted in newly-diagnosed ALL patients aged 1 to 18 years who underwent induction phase chemotherapy at Haji Adam Malik General Hospital, Medan, North Sumatera. Mid-upper arm circumference (MUAC) was used to determine nutritional status. Patient characteristics such as complete blood count (CBC) at the time of diagnosis, occurrence of febrile neutropenia, duration of induction, length of hospital stay, and remission status were collected. We analyzed differences in CBC, frequency of febrile neutropenia, as well as duration of induction and hospital stay between well-nourished and malnourished patients. We also assessed the difference in remission attainment between the two groups. \u0000Results There were 21 subjects in each group. Compared to well-nourished subjects, malnourished ones had a higher median incidence of febrile neutropenia [1 (range 0 to 30) vs. 3 (range 0 to 4); P=0.04], longer mean induction duration [64.2 (SD 11.5) vs. 71.2 (SD 10.6) days; P=0.046], and longer median hospital stay [30 (range 19 to 56) vs. 36 (range 22 to 49) days; P=0.001] compared to well-nourished subjects. There was no significant difference in CBC parameters and remission status after induction between the two groups. \u0000Conclusion Malnourished pediatric ALL patients had a significantly higher incidence of febrile neutropenia, duration of induction phase, and duration of hospital stay compared to well-nourished ALL patients.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"72 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73599006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary arteriovenous malformation as a cause of exercise intolerance in children: a case report 肺动静脉畸形是儿童运动不耐受的一种病因:1例报告
Q4 PEDIATRICS Pub Date : 2023-06-27 DOI: 10.14238/pi63.3.2023.208-12
Pierluigi Morreale, Veronica Notarbartolo, Giancarlo Allegro, Mario Giuseppe Vallone, Francesca Finazzo, Vincenzo Antona, Maria Fiorella Sanfilippo, Calogero Comparato
Pulmonary arteriovenous malformations (PAVMs) in children are rare lesions characterized by abnormal low resistance vascular structures connecting a pulmonary artery to a pulmonary vein, resulting in an intrapulmonary right-to-left shunt. The insidious onset and variable signs and symptoms make diagnosis difficult, especially in children. PAVMs can be single or multiple, congenital or acquired, and up to 47-80% of cases are associated with hereditary hemorrhagic telangiectasia (HHT).
儿童肺动静脉畸形(pavm)是一种罕见的病变,其特征是连接肺动脉和肺静脉的异常低阻力血管结构,导致肺内右至左分流。潜伏的发病和多变的体征和症状使诊断困难,特别是在儿童中。pavm可为单发或多发,先天性或获得性,高达47-80%的病例与遗传性出血性毛细血管扩张(HHT)有关。
{"title":"Pulmonary arteriovenous malformation as a cause of exercise intolerance in children: a case report","authors":"Pierluigi Morreale, Veronica Notarbartolo, Giancarlo Allegro, Mario Giuseppe Vallone, Francesca Finazzo, Vincenzo Antona, Maria Fiorella Sanfilippo, Calogero Comparato","doi":"10.14238/pi63.3.2023.208-12","DOIUrl":"https://doi.org/10.14238/pi63.3.2023.208-12","url":null,"abstract":"Pulmonary arteriovenous malformations (PAVMs) in children are rare lesions characterized by abnormal low resistance vascular structures connecting a pulmonary artery to a pulmonary vein, resulting in an intrapulmonary right-to-left shunt. The insidious onset and variable signs and symptoms make diagnosis difficult, especially in children. PAVMs can be single or multiple, congenital or acquired, and up to 47-80% of cases are associated with hereditary hemorrhagic telangiectasia (HHT).","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"269 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135503203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Translation, cultural adaptation, and validation of the Indonesian version of Pediatric Quality of Life Inventory Rheumatology Module (PedsQL-RM) questionnaire for children with rheumatic diseases 印尼版儿童生活质量量表风湿病模块(PedsQL-RM)调查问卷的翻译、文化适应和验证
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-06-26 DOI: 10.14238/pi63.3.2023.136-45
G. Ilmana, Z. Munasir, N. Chozie, B. Medise
Background Quality of life is an important outcome in the management of children with chronic conditions such as rheumatic diseases. The Pediatric Quality of Life Inventory Rheumatology Module (PedsQL-RM) questionnaire has been proven valid and reliable, but a validated Indonesian version of the questionnaire is not yet available. Objective To translate the PedsQL-RM into the Indonesian language, perform a transcultural adaptation, and assess its validity. Methods A cross-sectional study was performed in patients aged 2 to 18 years with systemic lupus erythematosus (SLE) or juvenile idiopathic arthritis (JIA) in Dr. Cipto Mangunkusumo Hospital, Jakarta. The initial phase of the study consisted of forward translation from the original English version into Indonesian, synthesis by experts, backward translation, and cognitive debriefing, resulting in the final version of the questionnaire. The second phase was testing the final questionnaire on patients in each age group and their parents. Tests were carried out in two sessions with an interval of 2 to 4 weeks. The questionnaire consisted of a child report and a parent report, each measuring five dimensions: pain and hurt, activities, treatment, worry, and communication. We subsequently assessed validity and reliability of each dimension in the child and parent reports for the child and teen age groups. Validity was expressed as correlation coefficient (r) between dimension scores with the total score. Results The finalized Indonesian questionnaire was completed by 53 children aged 2-18 years with SLE or JIA and their parents. Due to small numbers of subjects in the younger age ranges, analysis was only performed in the 8-to-18-year age group. Validity varied from good to very good (r = 0.437 to 0.910) for the child report and from poor to good (r = 0.153 to 0.808) for the parent report. The questionnaire was deemed reliable, with a Cronbach’s alpha of 0.755 to 0.785. Conclusion The Indonesian version of the PedsQL-RM is valid and reliable for assessing quality of life in children aged 8 to 18 years with rheumatologic disease. Further study is needed to assess the validity and reliability of the tool for children aged 2 to 7 years.
生活质量是治疗儿童慢性疾病(如风湿性疾病)的一个重要结果。儿科生活质量量表风湿病模块(PedsQL-RM)问卷已被证明是有效和可靠的,但尚未有经过验证的印尼语版本的问卷。目的将PedsQL-RM翻译成印尼语,进行跨文化改编,并评估其有效性。方法对雅加达Cipto Mangunkusumo医院2 ~ 18岁系统性红斑狼疮(SLE)或青少年特发性关节炎(JIA)患者进行横断面研究。研究的初始阶段包括将原英文版本向前翻译成印尼语,专家合成,后向翻译,认知汇报,最终形成问卷的最终版本。第二阶段是对每个年龄组的患者及其父母进行最终问卷测试。试验分两期进行,间隔2至4周。调查问卷包括一份儿童报告和一份家长报告,每一份报告都包含五个方面:疼痛和伤害、活动、治疗、担忧和沟通。我们随后评估了儿童和青少年年龄组儿童和家长报告中每个维度的有效性和可靠性。效度以各维度得分与总分的相关系数(r)表示。结果对53例2-18岁SLE或JIA患儿及其家长完成印尼语问卷定稿。由于年龄较小的受试者数量较少,因此仅对8- 18岁年龄组进行了分析。儿童报告的效度从好到非常好(r = 0.437至0.910),父母报告的效度从差到好(r = 0.153至0.808)。该问卷被认为是可靠的,Cronbach 's alpha在0.755到0.785之间。结论印尼版PedsQL-RM用于评估8 - 18岁风湿病患儿的生活质量是有效和可靠的。需要进一步的研究来评估该工具对2至7岁儿童的有效性和可靠性。
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引用次数: 0
The management of febrile seizures by pediatricians in Indonesia: adherence to 2016 Indonesian Pediatric Society recommendations and influencing factors 印度尼西亚儿科医生对热性惊厥的管理:遵守2016年印度尼西亚儿科学会的建议和影响因素
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-04-17 DOI: 10.14238/pi63.2.2023.119-28
Amanda Soebadi, Rivaldo Suhito, S. Handryastuti
Background Although febrile seizures are generally benign, judicious management is needed to prevent inadequate or excessive management. In 2016, the Indonesian Pediatric Society (IPS) issued Recommendations for the Management of Febrile Seizures, but it is unclear whether pediatricians follow these recommendations in their clinical practice. Objectives To evaluate adherence to the 2016 IPS Recommendations for the Management of Febrile Seizures amongst pediatricians in Indonesia, as well as factors influencing adherence. Methods An anonymous online questionnaire was distributed by e-mail to IPS member pediatricians. We collected data on age, year of completion of pediatric residency or subspecialty training, practice region, type of practice, number of febrile seizure patients managed per month, and history of attending teaching sessions on the recommendations. We scored participants’ adherence to the recommendations in terms of pharmacologic treatment, ancillary testing, and prognosis. We also analyzed the difference in scores according to participant characteristics. Results Of 308 participants, 247 (80%) obtained a total adherence score of 50% or more of the highest possible score. Median total adherence score was 63.2% (range 20.6% to 100%) of the highest possible score. Median adherence scores were significantly higher in pediatricians who were 31 to 60-years-old vs. >60-years-old (64.7% vs. 52.9%, P=0.004), completed their residency training within the past <10 years vs. >10 years (64.7% vs. 61.8%, P=0.034), practiced in hospitals vs. clinics or private practices (61.8% vs. 50.0%, P=0.006), were aware vs. unaware of the recommendations (64.7% vs. 52.9%, P=0.02), and had vs. had not read the recommendations (62.7% vs. 50.0%, P=0.01). Most participants (93.5%) reported the recommendations to be feasible in their settings. Obstacles to implementation included lack of medication availability (8/20), lack of time to read the recommendations (8/20), lack of awareness of the recommendations (2/20), and limited infrastructure (2/20). Conclusions Most pediatricians in Indonesia have moderately good adherence to the 2016 IPS Recommendations for the Management of Febrile Seizures. Awareness of the recommendations needs to be raised further and limitations in medication distribution and infrastructure need to be overcome for better adherence.
背景:虽然热性惊厥通常是良性的,但需要明智的管理,以防止管理不足或过度。2016年,印度尼西亚儿科学会(IPS)发布了《热性癫痫发作管理建议》,但目前尚不清楚儿科医生是否在临床实践中遵循这些建议。目的评估印度尼西亚儿科医生对2016年IPS热性癫痫发作管理建议的依从性,以及影响依从性的因素。方法通过电子邮件向IPS会员儿科医师发放匿名在线问卷。我们收集了年龄、完成儿科住院医师或亚专科培训的年份、执业区域、执业类型、每月管理的热性惊厥患者数量以及参加建议教学课程的历史等数据。我们根据药物治疗、辅助测试和预后对参与者的依从性进行评分。我们还根据参与者的特征分析了得分的差异。结果308名参与者中,247名(80%)获得了最高可能分数的50%或更高的总依从性得分。中位总依从性得分为最高可能得分的63.2%(范围20.6%至100%)。31 - 60岁的儿科医生与60岁的儿科医生(64.7% vs. 52.9%, P=0.004)、在过去10年内完成住院医师培训的儿科医生(64.7% vs. 61.8%, P=0.034)、在医院执业的儿科医生与在诊所或私人诊所执业的儿科医生(61.8% vs. 50.0%, P=0.006)、知道和不知道这些建议的儿科医生(64.7% vs. 52.9%, P=0.02)、读过和没有读过这些建议的儿科医生(62.7% vs. 50.0%, P=0.01)的依从性得分中位数显著高于60岁的儿科医生(64.7% vs. 50.0%, P=0.01)。大多数参与者(93.5%)报告这些建议在他们的环境中是可行的。实施的障碍包括缺乏药物可用性(8/20),没有时间阅读建议(8/20),缺乏对建议的认识(2/20)和有限的基础设施(2/20)。结论:印度尼西亚大多数儿科医生对2016年IPS热性癫痫发作管理建议的依从性较好。需要进一步提高对建议的认识,需要克服药物分配和基础设施方面的限制,以更好地遵守建议。
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引用次数: 0
A case report of multiple relapses of Henoch-Schonlein purpura 过敏性紫癜多次复发1例
IF 0.2 Q4 PEDIATRICS Pub Date : 2023-04-11 DOI: 10.14238/pi63.2.2023.134-8
Afrilia Intan Pratiwi, Sumadiono Sumadiono, M. Sitaresmi
Henoch-Schonlein Purpura (HSP) is an acute immunoglobulin A (IgA)–mediated disorder characterized by generalized vasculitis. HSP commonly occurs in children. The annual worldwide incidence is 13-20 per 100,000 children under 17 years of age.1–3 It is characterized by non-thrombocytopenic palpable purpura mostly located on the dependent parts like lower extremities and buttocks, arthralgia/arthritis, bowel angina, and hematuria/proteinuria. HSP pathophysiology is not yet completely understood. Genetic factors are thought to drive the fundamental susceptibility and clinical manifestations. Proposed triggering factors include upper respiratory tract infections, medications, vaccinations, and malignancies. Disease course is usually benign and self-limited. Even though the prognosis is generally good, recurrences or relapses are common within 1 year of initial presentation.4
过敏性紫癜(HSP)是一种急性免疫球蛋白A (IgA)介导的疾病,以全身性血管炎为特征。热休克常见于儿童。全世界每年的发病率为每10万17岁以下儿童13-20例。1-3其特征为可触及的非血小板减少性紫癜,多发生在依赖部位,如下肢和臀部,关节痛/关节炎,肠绞痛,血尿/蛋白尿。热休克的病理生理机制尚不完全清楚。遗传因素被认为是驱动基本易感性和临床表现。提出的触发因素包括上呼吸道感染、药物、疫苗接种和恶性肿瘤。病程通常是良性和自限性的。尽管预后一般较好,但在首次出现后1年内复发或复发是常见的
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引用次数: 0
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Paediatrica Indonesiana
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