Pub Date : 2023-02-27DOI: 10.14238/pi63.1sup.2023.14-20
S. Yuliarto, Kurniawan Taufiq Kadafi, Dian Maharani, I. Ratridewi, S. L. Winaputri
Background Procalcitonin (PCT) level is one of known biomarker in septic diagnosis, but limited studies report its benefit in predicting the outcomes of children with sepsis. Neutrophil to lymphocyte (NLR) and mean platelet volume (MPV) are simple biomarkers of inflammation that can be measured in routine hematological examination which role in predicting organ dysfunction remain unclear. Objective To understand the correlations between PCT level, NLR, and MPV, tested in the first day of admission with outcomes of septic children in intensive care unit. Methods This retrospective cohort study obtained the data from medical record of pediatric patients admitted in PICU and HCU since January 2019. The inclusion criteria were children aged 1 months to 18 years with sepsis; whie exclusion criteria were patients with congenital heart disease, hematologic disease, malignancy, and length of care in intensive care unit less than 3 days or more than 28 days. The PCT, NLR, and MPV levels were assessed in the first day of admission. Organ dysfunction was identified using qSOFA score more than 2 points. Results Sixty-nine septic children were reviewed. Procalcitonin level in the first day of admission correlated significantly with qSOFA score in the third day of admission (R= 0.639; P=0.000); as well as with mortality (R=0.747; P=0.000). Receiver operating characteristic (ROC) curve of PCT level in the first day of admission had area under curve (AUC) of 0.922 to predict organ dysfunction (cut off 3.425; sensitivity 95.8%; specificity 52.4%) and AUC of 0.952 to predict mortality (cut off 21.165; sensitivity 96.4%; specificity 78%). Moreover, NLR in the first day of admission correlated significantly with qSOFA in the third day of admission (R=0.407; P=0.001), but did not correlate with mortality. The ROC of NLR to predict organ dysfunction was 0.829 (cut off 3.52; sensitivity 87.5%; specificity 66.7%). There was no correlation between MPV in the first day of admission with qSOFA score in the third day of admission neither with mortality. Linear regression test showed that PCT level and NLR in the first day of admission simultaneously had correlated with qSOFA score in the third day of admission (R=0.696; P= 0.000) and mortality (R=0.748; P=0.000). Meanwhile, PCT and MPV simultaneously had correlation with qSOFA score in the third day of admission (R=0.688; P=0.000) and mortality (R=0.733; P=0.000). Moreover, NLR and MPV simultaneously had correlation with qSOFA score in the third day of admission (R=0.453; P=0.002). All three independent variables (PCT level, NLR, and MPV) simultaneously correlated with qSOFA score in the third day of admission (R= 0.744; P=0.000) and mortality (R=0.739; P=0.000). Conclusion There are significant correlations between each, PCT level and NLR in the first day of admission with qSOFA score in the third day of admission as well as with mortality. There is no correlation between MPV in the first day of admission with qSO
{"title":"Procalcitonin level, neutrophil to lymphocyte count ratio, and mean platelet volume as predictors of organ dysfunction and mortality in children with sepsis","authors":"S. Yuliarto, Kurniawan Taufiq Kadafi, Dian Maharani, I. Ratridewi, S. L. Winaputri","doi":"10.14238/pi63.1sup.2023.14-20","DOIUrl":"https://doi.org/10.14238/pi63.1sup.2023.14-20","url":null,"abstract":"Background Procalcitonin (PCT) level is one of known biomarker in septic diagnosis, but limited studies report its benefit in predicting the outcomes of children with sepsis. Neutrophil to lymphocyte (NLR) and mean platelet volume (MPV) are simple biomarkers of inflammation that can be measured in routine hematological examination which role in predicting organ dysfunction remain unclear. \u0000Objective To understand the correlations between PCT level, NLR, and MPV, tested in the first day of admission with outcomes of septic children in intensive care unit. \u0000Methods This retrospective cohort study obtained the data from medical record of pediatric patients admitted in PICU and HCU since January 2019. The inclusion criteria were children aged 1 months to 18 years with sepsis; whie exclusion criteria were patients with congenital heart disease, hematologic disease, malignancy, and length of care in intensive care unit less than 3 days or more than 28 days. The PCT, NLR, and MPV levels were assessed in the first day of admission. Organ dysfunction was identified using qSOFA score more than 2 points. \u0000Results Sixty-nine septic children were reviewed. Procalcitonin level in the first day of admission correlated significantly with qSOFA score in the third day of admission (R= 0.639; P=0.000); as well as with mortality (R=0.747; P=0.000). Receiver operating characteristic (ROC) curve of PCT level in the first day of admission had area under curve (AUC) of 0.922 to predict organ dysfunction (cut off 3.425; sensitivity 95.8%; specificity 52.4%) and AUC of 0.952 to predict mortality (cut off 21.165; sensitivity 96.4%; specificity 78%). \u0000Moreover, NLR in the first day of admission correlated significantly with qSOFA in the third day of admission (R=0.407; P=0.001), but did not correlate with mortality. The ROC of NLR to predict organ dysfunction was 0.829 (cut off 3.52; sensitivity 87.5%; specificity 66.7%). There was no correlation between MPV in the first day of admission with qSOFA score in the third day of admission neither with mortality. \u0000Linear regression test showed that PCT level and NLR in the first day of admission simultaneously had correlated with qSOFA score in the third day of admission (R=0.696; P= 0.000) and mortality (R=0.748; P=0.000). Meanwhile, PCT and MPV simultaneously had correlation with qSOFA score in the third day of admission (R=0.688; P=0.000) and mortality (R=0.733; P=0.000). Moreover, NLR and MPV simultaneously had correlation with qSOFA score in the third day of admission (R=0.453; P=0.002). All three independent variables (PCT level, NLR, and MPV) simultaneously correlated with qSOFA score in the third day of admission (R= 0.744; P=0.000) and mortality (R=0.739; P=0.000). \u0000Conclusion There are significant correlations between each, PCT level and NLR in the first day of admission with qSOFA score in the third day of admission as well as with mortality. There is no correlation between MPV in the first day of admission with qSO","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"10 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83009559","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}
Pub Date : 2023-01-24DOI: 10.14238/pi63.1sup.2023.8-13
B. I. Corebima, E. Sulistijono, Widanto Widanto, Cheah Fook Choe
Background The outcomes of neonatal surgical cases has steadily improved in the last decade. However, limited local data are available in Indonesia regarding the contributing factors and outcomes of surgical procedures in neonates. Objective To determine the incidence of infection and mortality in neonatal surgical cases in Saiful Anwar Hospital, Malang, East Java, Indonesia. Methods This retrospective cohort study included neonates who underwent abdominal surgery over a period of 20 months from January 2021 to August 2022. Data collected included subjects’ basic demographics, primary surgical diagnoses, associated congenital anomalies, pre-operative conditions, and referral status. These parameters were analyzed in relation to the incidence of infection and mortality in the 30 days after surgical procedure. Results Of fifty-four neonates in this study, the most common neonatal surgical conditions were anorectal malformation, followed by necrotizing enterocolitis and Hirschsprung’s disease. The mortality rate at 30 days was 48%. The most common associated factors were sepsis (OR 0.778; 95%CI 0.233 to -1.167; P=0.041), pre-operative respiratory failure/hemodynamic instability (OR 2.129; 95%CI 1.039 to 3.126; P<0.001), and delayed referral (OR 0.295; 95%CI 0.074 to 1.177; P=0.048). Other factors such as age at presentation, gender, gestational age, birth weight, referral patient vs. those born in our hospital, associated congenital anomalies, and emergency procedures were not associated with mortality. The survival time in the sepsis group [17.30 (1.68-13.98) days] was significantly lower than in the non-sepsis group [25.95 (1.63-22.76) days] (P< 0.001). Conclusion Sepsis, pre-operative respiratory failure/hemodynamic instability, and delayed referral are risk factors for mortality in neonates following abdominal surgery. Identification of these risk factors and early intervention are important to improve outcomes.
{"title":"Factors associated with infection and mortality in neonates following abdominal surgery","authors":"B. I. Corebima, E. Sulistijono, Widanto Widanto, Cheah Fook Choe","doi":"10.14238/pi63.1sup.2023.8-13","DOIUrl":"https://doi.org/10.14238/pi63.1sup.2023.8-13","url":null,"abstract":"Background The outcomes of neonatal surgical cases has steadily improved in the last decade. However, limited local data are available in Indonesia regarding the contributing factors and outcomes of surgical procedures in neonates. \u0000Objective To determine the incidence of infection and mortality in neonatal surgical cases in Saiful Anwar Hospital, Malang, East Java, Indonesia. \u0000Methods This retrospective cohort study included neonates who underwent abdominal surgery over a period of 20 months from January 2021 to August 2022. Data collected included subjects’ basic demographics, primary surgical diagnoses, associated congenital anomalies, pre-operative conditions, and referral status. These parameters were analyzed in relation to the incidence of infection and mortality in the 30 days after surgical procedure. \u0000Results Of fifty-four neonates in this study, the most common neonatal surgical conditions were anorectal malformation, followed by necrotizing enterocolitis and Hirschsprung’s disease. The mortality rate at 30 days was 48%. The most common associated factors were sepsis (OR 0.778; 95%CI 0.233 to -1.167; P=0.041), pre-operative respiratory failure/hemodynamic instability (OR 2.129; 95%CI 1.039 to 3.126; P<0.001), and delayed referral (OR 0.295; 95%CI 0.074 to 1.177; P=0.048). Other factors such as age at presentation, gender, gestational age, birth weight, referral patient vs. those born in our hospital, associated congenital anomalies, and emergency procedures were not associated with mortality. The survival time in the sepsis group [17.30 (1.68-13.98) days] was significantly lower than in the non-sepsis group [25.95 (1.63-22.76) days] (P< 0.001). \u0000Conclusion Sepsis, pre-operative respiratory failure/hemodynamic instability, and delayed referral are risk factors for mortality in neonates following abdominal surgery. Identification of these risk factors and early intervention are important to improve outcomes.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"70 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81769992","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}
Pub Date : 2022-12-15DOI: 10.14238/pi62.6.2022.411-21
T. Fathan, A. Pudjiadi, Nina Dwi Putri, Nindya Permata, Yosilia Nursakina
Background Children are susceptible to SARS-CoV-2 infection and often present mild manifestations. However, severe and critical cases have also been reported. The inflammation and coagulation marker profile pattern in these patients along with the white blood cell differential count in critical PICU cases with non-COVID-19 etiology is not entirely clear. Objective To evaluate the inflammation and coagulation profiles in children presenting with severe/critical SARS-CoV-2 infection. Methods A systematic search and review of scientific literature was conducted following the PRISMA guidelines using ProQuest, SCOPUS, EBSCOHost, ScienceDirect, Cochrane, EMBASE, and Pubmed databases. All relevant original studies until March 11, 2021, were included. The risk of bias was appraised using the Modified Newcastle Ottawa Scale and JBI Critical Appraisal Checklist tools. Results We identified 14 studies across 6 countries, including a total sample of 159 severe and critically ill pediatric COVID-19 patients. Most of the subjects showed normal leukocytes, but increased CRP, procalcitonin, ferritin, and IL-6. Studies on coagulation profiles showed normal thrombocytes, PT, aPTT, and inconsistent D-dimer results. Conclusion Inflammation and coagulation parameters in severe/critically ill children with COVID-19 are atypical. Several inflammatory markers were elevated, including CRP, ferritin, procalcitonin, and IL-6. However, the elevated marker values are still lower compared to non-COVID infection patients. Further investigation of the parameters need to be done in serial examination multicenter studies, which include control subjects.
{"title":"Inflammatory and coagulation marker profiles in severe pediatric COVID-19 patients: a systematic review","authors":"T. Fathan, A. Pudjiadi, Nina Dwi Putri, Nindya Permata, Yosilia Nursakina","doi":"10.14238/pi62.6.2022.411-21","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.411-21","url":null,"abstract":"Background Children are susceptible to SARS-CoV-2 infection and often present mild manifestations. However, severe and critical cases have also been reported. The inflammation and coagulation marker profile pattern in these patients along with the white blood cell differential count in critical PICU cases with non-COVID-19 etiology is not entirely clear. \u0000Objective To evaluate the inflammation and coagulation profiles in children presenting with severe/critical SARS-CoV-2 infection. \u0000Methods A systematic search and review of scientific literature was conducted following the PRISMA guidelines using ProQuest, SCOPUS, EBSCOHost, ScienceDirect, Cochrane, EMBASE, and Pubmed databases. All relevant original studies until March 11, 2021, were included. The risk of bias was appraised using the Modified Newcastle Ottawa Scale and JBI Critical Appraisal Checklist tools. \u0000Results We identified 14 studies across 6 countries, including a total sample of 159 severe and critically ill pediatric COVID-19 patients. Most of the subjects showed normal leukocytes, but increased CRP, procalcitonin, ferritin, and IL-6. Studies on coagulation profiles showed normal thrombocytes, PT, aPTT, and inconsistent D-dimer results. \u0000Conclusion Inflammation and coagulation parameters in severe/critically ill children with COVID-19 are atypical. Several inflammatory markers were elevated, including CRP, ferritin, procalcitonin, and IL-6. However, the elevated marker values are still lower compared to non-COVID infection patients. Further investigation of the parameters need to be done in serial examination multicenter studies, which include control subjects.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"28 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75734947","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}
Pub Date : 2022-12-06DOI: 10.14238/pi62.6.2022.390-5
Meily Elven Nora, I. Murni, Sasmito Nugroho, Noormanto Noormanto
Background Heart failure continues to be a significant contributor to morbidity and mortality in children with congenital heart disease (CHD). Little is known about heart failure in children. Identifying predictors of heart failure in children with CHD can serve to guide preventive strategies to heart failure. Objective To understand the predictors of heart failure of children with congenital heart disease. Methods A nested, case-control study was performed using secondary data based on a prospective study previously conducted in Dr Sardjito Tertiary Hospital in Yogyakarta in years 2011-2013. We included children aged 1 month-18 years who had been diagnosed with CHD by echocardiography. Age, sex, type of CHD, CHD complexity, as well as presence of syndrome, no pulmonary obstruction, pneumonia, and malnutrition were analyzed as potential predictors of heart failure. Results are presented as odds ratios (OR) with 95% confidence intervals (95%CI). Results A total of 2,646 children were hospitalized in Dr Sardjito Tertiary Hospital during the study period. Congenital heart disease was noted in 216 children (8.16%), 200 (7.5%) of whom met the inclusion criteria. The 100 children with heart failure had median age of 1.5 years and 15% died during hospitalization. Multivariate analysis revealed that acyanotic CHD (OR 2.69; 95%CI 1.45 to 5.00), no pulmonary obstruction (OR 3.05; 95%CI 1.33 to 6.99) and the presence of pneumonia (OR 2.04; 95%CI 1.03 to 4.06) were statistically significant as independent predictors of heart failure in children with CHD. However, sex, age, CHD complexity, as well as presence of a syndrome, and malnutrition were not significantly associated with heart failure in children with CHD. Conclusion The predictors of heart failure in children with CHD were acyanotic CHD, no pulmonary obstruction, and presence of pneumonia.
{"title":"Predictors of heart failure in children with congenital heart disease","authors":"Meily Elven Nora, I. Murni, Sasmito Nugroho, Noormanto Noormanto","doi":"10.14238/pi62.6.2022.390-5","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.390-5","url":null,"abstract":"Background Heart failure continues to be a significant contributor to morbidity and mortality in children with congenital heart disease (CHD). Little is known about heart failure in children. Identifying predictors of heart failure in children with CHD can serve to guide preventive strategies to heart failure. \u0000Objective To understand the predictors of heart failure of children with congenital heart disease. \u0000Methods A nested, case-control study was performed using secondary data based on a prospective study previously conducted in Dr Sardjito Tertiary Hospital in Yogyakarta in years 2011-2013. We included children aged 1 month-18 years who had been diagnosed with CHD by echocardiography. Age, sex, type of CHD, CHD complexity, as well as presence of syndrome, no pulmonary obstruction, pneumonia, and malnutrition were analyzed as potential predictors of heart failure. Results are presented as odds ratios (OR) with 95% confidence intervals (95%CI). \u0000Results A total of 2,646 children were hospitalized in Dr Sardjito Tertiary Hospital during the study period. Congenital heart disease was noted in 216 children (8.16%), 200 (7.5%) of whom met the inclusion criteria. The 100 children with heart failure had median age of 1.5 years and 15% died during hospitalization. Multivariate analysis revealed that acyanotic CHD (OR 2.69; 95%CI 1.45 to 5.00), no pulmonary obstruction (OR 3.05; 95%CI 1.33 to 6.99) and the presence of pneumonia (OR 2.04; 95%CI 1.03 to 4.06) were statistically significant as independent predictors of heart failure in children with CHD. However, sex, age, CHD complexity, as well as presence of a syndrome, and malnutrition were not significantly associated with heart failure in children with CHD. \u0000Conclusion The predictors of heart failure in children with CHD were acyanotic CHD, no pulmonary obstruction, and presence of pneumonia.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"2 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78538198","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}
Pub Date : 2022-12-05DOI: 10.14238/pi62.6.2022.404-10
Fifi Febria Ningsih, H. Abdillah, S. Nafianti
Background Incidence of congenital heart disease (CHD) is about 0.8% of every child born. This heart defect is associated with dyslipidemia in children. Lipid profiles examination in patients with CHD can be used to determine risk factors for atherosclerosis. Objective To examine differences in lipid profiles in children with cyanotic and acyanotic CHD. Methods This was a cross-sectional study on 60 pediatric CHD patients at Haji Adam Malik Hospital, Medan, North Sumatera, from December 2020 to March 2021. Subjects were included by consecutive sampling. Data of patient’s age, gender, weight, height, complete blood count, blood glucose, and lipid profiles were recorded. Unpaired T-test analysis and Mann-Whitney test were then performed to analyze variables in cyanotic and acyanotic CHD patients. Results Of a total of 60 CHD children, 26 subjects had a diagnosis of cyanotic CHD and 34 subjects had a diagnosis of acyanotic CHD. The most common cause of cyanotic CHD was tetralogy of Fallot (76.9%), while the most common cause of acyanotic CHD were ventricular septal defect and patent ductus arteriosus (32.4% each). Analysis of lipid profiles on both groups revealed that low density lipoprotein (LDL) was significantly lower in the cyanotic group than in the acyanotic group (P<0.05). However, other lipid profile values, were not significantly different between groups. In addition, there was no significant difference in incidence of dyslipidemia between cyanotic and acyanotic CHD. Conclusion Low density lipoprotein is significantly lower in the cyanotic CHD group than in the acyanotic CHD group. But there are no significant differences in the other lipid profiles measurement and incidence of dyslipidemia between groups.
背景先天性心脏病(CHD)的发病率约为每个出生儿童的0.8%。这种心脏缺陷与儿童血脂异常有关。冠心病患者的血脂检查可用于确定动脉粥样硬化的危险因素。目的探讨青紫型和无青紫型冠心病患儿血脂的差异。方法对2020年12月至2021年3月期间在北苏门答腊棉兰Haji Adam Malik医院就诊的60例儿科冠心病患者进行横断面研究。采用连续抽样方法纳入研究对象。记录患者的年龄、性别、体重、身高、全血细胞计数、血糖、血脂等资料。然后采用非配对t检验和Mann-Whitney检验分析青紫型和无青紫型冠心病患者的变量。结果60例冠心病患儿中，26例诊断为紫型冠心病，34例诊断为无紫型冠心病。青紫型冠心病最常见的病因是法洛四联症(76.9%)，无青紫型冠心病最常见的病因是室间隔缺损和动脉导管未闭(32.4%)。两组脂质谱分析显示，青绀组低密度脂蛋白(LDL)显著低于无氰组(P<0.05)。然而，其他血脂值，组间无显著差异。此外，青紫型冠心病和无青紫型冠心病的血脂异常发生率无显著差异。结论青紫型冠心病组低密度脂蛋白明显低于无青紫型冠心病组。但在其他血脂测量和血脂异常发生率方面，两组间无显著差异。
{"title":"Comparison of lipid profile values in pediatric patients with cyanotic and acyanotic congenital heart disease","authors":"Fifi Febria Ningsih, H. Abdillah, S. Nafianti","doi":"10.14238/pi62.6.2022.404-10","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.404-10","url":null,"abstract":"Background Incidence of congenital heart disease (CHD) is about 0.8% of every child born. This heart defect is associated with dyslipidemia in children. Lipid profiles examination in patients with CHD can be used to determine risk factors for atherosclerosis. \u0000Objective To examine differences in lipid profiles in children with cyanotic and acyanotic CHD. \u0000Methods This was a cross-sectional study on 60 pediatric CHD patients at Haji Adam Malik Hospital, Medan, North Sumatera, from December 2020 to March 2021. Subjects were included by consecutive sampling. Data of patient’s age, gender, weight, height, complete blood count, blood glucose, and lipid profiles were recorded. Unpaired T-test analysis and Mann-Whitney test were then performed to analyze variables in cyanotic and acyanotic CHD patients. \u0000Results Of a total of 60 CHD children, 26 subjects had a diagnosis of cyanotic CHD and 34 subjects had a diagnosis of acyanotic CHD. The most common cause of cyanotic CHD was tetralogy of Fallot (76.9%), while the most common cause of acyanotic CHD were ventricular septal defect and patent ductus arteriosus (32.4% each). Analysis of lipid profiles on both groups revealed that low density lipoprotein (LDL) was significantly lower in the cyanotic group than in the acyanotic group (P<0.05). However, other lipid profile values, were not significantly different between groups. In addition, there was no significant difference in incidence of dyslipidemia between cyanotic and acyanotic CHD. \u0000Conclusion Low density lipoprotein is significantly lower in the cyanotic CHD group than in the acyanotic CHD group. But there are no significant differences in the other lipid profiles measurement and incidence of dyslipidemia between groups.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"244 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80562181","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}
Pub Date : 2022-12-05DOI: 10.14238/pi62.6.2022.396-403
Niken Iswarajati, I. Kumara, A. Triono
Background Status epilepticus (SE) is a neurological emergency, with short-term mortality ranging from 0.9 to 3.6% in children. The disease burden of SE includes morbidity, treatment costs, and mortality. Various scoring tools for predicting outcomes in adult SE cases have been widely studied, but there are few tools for predicting outcomes in children with SE. Objective To evaluate the usefulness of status epilepticus in pediatric patients severity score (STEPSS), a clinical score for predicting functional outcome and mortality in pediatric patients with status epilepticus, as well as to identify characteristics of SE patients. Methods This retrospective cohort study included 88 pediatric patients with status epilepticus aged >1 month to ?18 years by consecutive sampling, who were treated at Dr. Sardjito Hospital, Yogyakarta. All subjects underwent assessment by STEPPS score, which were compared to functional outcome assessed by Pediatric Overall Performance Capacity (POPC) score and mortality. Results STEPPS > 3 was significantly correlated with poor functional outcome (OR 2.85; 95%CI 1.04 to 7.87; P=0.043), but was not significantly correlated with mortality outcome in children with SE (P=0.411). Conclusion STEPPS score with cut-off >3 can be used as a predictor of poor functional outcome in pediatric patients with SE aged >1 month to ?18 years, but cannot be used as a predictor of mortality.
{"title":"Status epilepticus in pediatric patients severity score (STEPPS) as an outcome predictor in children","authors":"Niken Iswarajati, I. Kumara, A. Triono","doi":"10.14238/pi62.6.2022.396-403","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.396-403","url":null,"abstract":"Background Status epilepticus (SE) is a neurological emergency, with short-term mortality ranging from 0.9 to 3.6% in children. The disease burden of SE includes morbidity, treatment costs, and mortality. Various scoring tools for predicting outcomes in adult SE cases have been widely studied, but there are few tools for predicting outcomes in children with SE. \u0000Objective To evaluate the usefulness of status epilepticus in pediatric patients severity score (STEPSS), a clinical score for predicting functional outcome and mortality in pediatric patients with status epilepticus, as well as to identify characteristics of SE patients. \u0000Methods This retrospective cohort study included 88 pediatric patients with status epilepticus aged >1 month to ?18 years by consecutive sampling, who were treated at Dr. Sardjito Hospital, Yogyakarta. All subjects underwent assessment by STEPPS score, which were compared to functional outcome assessed by Pediatric Overall Performance Capacity (POPC) score and mortality. \u0000Results STEPPS > 3 was significantly correlated with poor functional outcome (OR 2.85; 95%CI 1.04 to 7.87; P=0.043), but was not significantly correlated with mortality outcome in children with SE (P=0.411). \u0000Conclusion STEPPS score with cut-off >3 can be used as a predictor of poor functional outcome in pediatric patients with SE aged >1 month to ?18 years, but cannot be used as a predictor of mortality.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74839725","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}
Pub Date : 2022-12-05DOI: 10.14238/pi62.6.2022.382-9
Hamdi Metin, P. Ertan, Ahmet KeskinoÄŸlu, E. Türköz Uluer, M. B. Batır, Pembe KeskinoÄŸlu, D. Akogullari, F. Çam
Background Renoprotective effects of vitamin D analogues have been shown in several experimental and clinical studies, the exact mechanism of the therapeutic effectiveness of these analogues in Nephrotic syndrome remains unclear, and these are relatively few studies on potential treatment roles for vitamin D analogues in nephrotic-range proteinuria. ?ndicate similar efficacy of the vitamin D analogues calcitriol and paricalcitol in time-limited amelioration of proteinuria in nephrotic syndrome, yet suggest the likelihood of mechanisms other than direct upregulation of nephrin and podocin in podocytes underlie the renoprotective effects of vitamin D analogues. Objective To investigate the effect of vitamin D (Vit D) analogues calcitriol and paricalcitol on urinary protein/creatinine ratio (UPCR) and renal podocin and nephrin expression in a rat model of puromycin aminonucleoside (PAN)-induced nephrotic syndrome (NS). Methods A total of 28 male Wistar Albino rats were separated into 4 groups (n=7 for each) including CON [control; intraperitoneal (IP) saline injection], PAN (NS + IP saline injection), PAN-C (NS + IP 0.4 µg/kg/day calcitriol injection), and PAN-P (NS + IP 240 ng/kg/day paricalcitol injection). Nephrotic syndrome was induced via intravenous (IV) administration of 10mg/100gr PAN. The UPCR as well as histopathological, immuno-histochemical, and real time PCR analyses of kidney tissue specimens were recorded and analyzed among the 4 groups. Results Median UPCR (Day 4) was significantly lower in both the PAN-C [1.45 (range 1.20-1.80)] and PAN-P [1.40 (range 1.10-1.80)] groups than in the PAN group [2.15 (range 2.00-2.40)] (P<0.01 for each). The PAN group had significantly higher mean UPCR than the CON group [1.75 (range 1.40-2.00); P<0.05]. No significant difference in UPCR was noted between groups on Day 7. Median podocin mRNA expression was significantly higher in the PAN-P group compared to the PAN group [22.55 (range 22.42-23.02) vs. 22.06 (range 21.81-22.06), respectively; (P<0.01)]. Conclusion Seven-day calcitriol and paricalcitol supplementation in a rat model of PAN-induced nephrotic syndrome had similar efficacy, in terms of temporary amelioration of proteinuria.
背景维生素D类似物的肾保护作用已经在一些实验和临床研究中得到证实，但这些类似物治疗肾病综合征的确切机制尚不清楚，关于维生素D类似物在肾病性蛋白尿中的潜在治疗作用的研究相对较少。研究表明，维生素D类似物骨化三醇和特立糖醇在肾病综合征蛋白尿的时限改善方面具有相似的功效，但表明维生素D类似物的肾保护作用可能不是直接上调足细胞中的肾素和足蛋白，而是其他机制。目的探讨维生素D (Vit D)类似物骨化三醇和异糖醇对嘌呤霉素氨基核苷(PAN)所致肾病综合征(NS)模型大鼠尿蛋白/肌酐比(UPCR)及肾足素和肾素表达的影响。方法雄性Wistar Albino大鼠28只，随机分为4组，每组7只，对照组;腹腔内(IP)生理盐水注射]、PAN (NS + IP生理盐水注射)、PAN- c (NS + IP 0.4µg/kg/d骨化三醇注射)、PAN- p (NS + IP 240 ng/kg/d特泊糖醇注射)。通过静脉(IV)给药10mg/100gr PAN诱导肾病综合征。记录并分析4组肾组织标本的UPCR及组织病理学、免疫组织化学和实时PCR分析。结果PAN- c组[1.45(1.20-1.80)]和PAN-P组[1.40(1.10-1.80)]的中位UPCR(第4天)均显著低于PAN组[2.15 (2.00-2.40)](P均<0.01)。PAN组平均UPCR显著高于CON组[1.75 (1.40 ~ 2.00);P < 0.05)。第7天各组间UPCR无显著差异。PAN- p组中位podocin mRNA表达量显著高于PAN组[分别为22.55(22.42-23.02)和22.06 (21.81-22.06)];(P < 0.01)。结论在pan肾病综合征大鼠模型中，补充7天骨化三醇和白藜芦醇在暂时性改善蛋白尿方面具有相似的疗效。
{"title":"Effect of vitamin D analogues calcitriol and paricalcitol in a rat model of puromycin aminonucleoside-induced nephrotic syndrome","authors":"Hamdi Metin, P. Ertan, Ahmet KeskinoÄŸlu, E. Türköz Uluer, M. B. Batır, Pembe KeskinoÄŸlu, D. Akogullari, F. Çam","doi":"10.14238/pi62.6.2022.382-9","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.382-9","url":null,"abstract":"Background Renoprotective effects of vitamin D analogues have been shown in several experimental and clinical studies, the exact mechanism of the therapeutic effectiveness of these analogues in Nephrotic syndrome remains unclear, and these are relatively few studies on potential treatment roles for vitamin D analogues in nephrotic-range proteinuria. ?ndicate similar efficacy of the vitamin D analogues calcitriol and paricalcitol in time-limited amelioration of proteinuria in nephrotic syndrome, yet suggest the likelihood of mechanisms other than direct upregulation of nephrin and podocin in podocytes underlie the renoprotective effects of vitamin D analogues. \u0000Objective To investigate the effect of vitamin D (Vit D) analogues calcitriol and paricalcitol on urinary protein/creatinine ratio (UPCR) and renal podocin and nephrin expression in a rat model of puromycin aminonucleoside (PAN)-induced nephrotic syndrome (NS). \u0000Methods A total of 28 male Wistar Albino rats were separated into 4 groups (n=7 for each) including CON [control; intraperitoneal (IP) saline injection], PAN (NS + IP saline injection), PAN-C (NS + IP 0.4 µg/kg/day calcitriol injection), and PAN-P (NS + IP 240 ng/kg/day paricalcitol injection). Nephrotic syndrome was induced via intravenous (IV) administration of 10mg/100gr PAN. The UPCR as well as histopathological, immuno-histochemical, and real time PCR analyses of kidney tissue specimens were recorded and analyzed among the 4 groups. \u0000Results Median UPCR (Day 4) was significantly lower in both the PAN-C [1.45 (range 1.20-1.80)] and PAN-P [1.40 (range 1.10-1.80)] groups than in the PAN group [2.15 (range 2.00-2.40)] (P<0.01 for each). The PAN group had significantly higher mean UPCR than the CON group [1.75 (range 1.40-2.00); P<0.05]. No significant difference in UPCR was noted between groups on Day 7. Median podocin mRNA expression was significantly higher in the PAN-P group compared to the PAN group [22.55 (range 22.42-23.02) vs. 22.06 (range 21.81-22.06), respectively; (P<0.01)]. \u0000Conclusion Seven-day calcitriol and paricalcitol supplementation in a rat model of PAN-induced nephrotic syndrome had similar efficacy, in terms of temporary amelioration of proteinuria.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"94 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86715376","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}
Pub Date : 2022-12-05DOI: 10.14238/pi62.6.2022.373-81
F. B. H. Jonathan, A. T. Sridevi, B. A. Wicaksono, Dewi Friska, B. Hegar
Background The diagnostic criteria of infant regurgitation have been well elucidated in the Rome IV criteria and pediatricians have been informed of them. However, as a functional disorder, infant regurgitation is susceptible to misdiagnosis and inappropriate management. Objective To assess pediatricians’ diagnostic knowledge of and therapeutic approach to infant regurgitation. Methods We conducted a cross-sectional, analytical study using a questionnaire based on Rome IV criteria for infant regurgitation diagnosis and standardized guidelines for management. The questionnaire was face-level validated by an expert and tested for both reliability and correlation using 30 test respondents. The questionnaire was then distributed electronically to 131 randomized pediatricians, who were members of the Indonesian Pediatric Society DKI Jakarta branch and graduated from pediatric residency within year 2005-2019. Results Sixty-seven (51%) pediatricians reported applying the Rome IV criteria in daily clinical practice. Pediatricians who used Rome IV as their source of knowledge achieved mean and median diagnostic knowledge scores of 14.87 (SD 2.540) and 16 (range 8–20), respectively, with no significant correlation between the usage of ROME IV and the pediatricians’ diagnostic understanding (P=0.110), and mean and median therapeutic knowledge scores of 9.10 (SD 2.264) and 10 (range 4–12), respectively, with no significant correlation between the usage of ROME IV and the pediatricians’ therapeutic approach (P=0.486). Pediatricians’ diagnostic knowledge and therapeutic approach were not significantly different with regards to their practice experience, specialist institution, workplaces, and source of information. Conclusion The majority of pediatricians surveyed have good diagnostic and therapeutic knowledge scores with regards to handling of Rome IV infant regurgitation.
{"title":"Indonesian pediatricians’ understanding and management of infant regurgitation based on Rome IV criteria","authors":"F. B. H. Jonathan, A. T. Sridevi, B. A. Wicaksono, Dewi Friska, B. Hegar","doi":"10.14238/pi62.6.2022.373-81","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.373-81","url":null,"abstract":"Background The diagnostic criteria of infant regurgitation have been well elucidated in the Rome IV criteria and pediatricians have been informed of them. However, as a functional disorder, infant regurgitation is susceptible to misdiagnosis and inappropriate management. \u0000Objective To assess pediatricians’ diagnostic knowledge of and therapeutic approach to infant regurgitation. \u0000Methods We conducted a cross-sectional, analytical study using a questionnaire based on Rome IV criteria for infant regurgitation diagnosis and standardized guidelines for management. The questionnaire was face-level validated by an expert and tested for both reliability and correlation using 30 test respondents. The questionnaire was then distributed electronically to 131 randomized pediatricians, who were members of the Indonesian Pediatric Society DKI Jakarta branch and graduated from pediatric residency within year 2005-2019. \u0000Results Sixty-seven (51%) pediatricians reported applying the Rome IV criteria in daily clinical practice. Pediatricians who used Rome IV as their source of knowledge achieved mean and median diagnostic knowledge scores of 14.87 (SD 2.540) and 16 (range 8–20), respectively, with no significant correlation between the usage of ROME IV and the pediatricians’ diagnostic understanding (P=0.110), and mean and median therapeutic knowledge scores of 9.10 (SD 2.264) and 10 (range 4–12), respectively, with no significant correlation between the usage of ROME IV and the pediatricians’ therapeutic approach (P=0.486). Pediatricians’ diagnostic knowledge and therapeutic approach were not significantly different with regards to their practice experience, specialist institution, workplaces, and source of information. \u0000Conclusion The majority of pediatricians surveyed have good diagnostic and therapeutic knowledge scores with regards to handling of Rome IV infant regurgitation.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79466511","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}
Pub Date : 2022-12-05DOI: 10.14238/pi62.6.2022.422-9
I. K. A. Utamayasa, Mia Puspitasari, Taufiq Hidayat, M. A. Rahman
Takayasu arteritis (TA) is defined as granulomatous inflammation of large arteries involving the aorta and its primary branches. Takayasu arteritis with renal artery stenosis (TARAS) is a common cause of pediatric renovascular hypertension. The main purposes of TARAS management are to improve high blood pressure and recover renal function. When general medication fails to improve symptoms, renal revascularization may be attempted. Implantation of a drug-eluting stent (DES) has been used as an alternative strategy for pediatric renal revascularization. Here, we report on a 10-year-old, female, Javanese patient with bilateral TARAS who underwent DES implantation. Her clinical presentation was hypertensive crisis and worsened renal function. Bilateral renal artery DES implantation was performed successfully without complications. The child’s blood pressure was controlled using two anti-hypertensive medications after DES implantation and her renal function recovered. Dual anti-platelet therapy was given to minimize the risk of stent thrombosis.
{"title":"Role of drug-eluting stent on Takayasu arteritis with renal artery stenosis","authors":"I. K. A. Utamayasa, Mia Puspitasari, Taufiq Hidayat, M. A. Rahman","doi":"10.14238/pi62.6.2022.422-9","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.422-9","url":null,"abstract":"Takayasu arteritis (TA) is defined as granulomatous inflammation of large arteries involving the aorta and its primary branches. Takayasu arteritis with renal artery stenosis (TARAS) is a common cause of pediatric renovascular hypertension. The main purposes of TARAS management are to improve high blood pressure and recover renal function. When general medication fails to improve symptoms, renal revascularization may be attempted. Implantation of a drug-eluting stent (DES) has been used as an alternative strategy for pediatric renal revascularization. Here, we report on a 10-year-old, female, Javanese patient with bilateral TARAS who underwent DES implantation. Her clinical presentation was hypertensive crisis and worsened renal function. Bilateral renal artery DES implantation was performed successfully without complications. The child’s blood pressure was controlled using two anti-hypertensive medications after DES implantation and her renal function recovered. Dual anti-platelet therapy was given to minimize the risk of stent thrombosis.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82202970","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}
Pub Date : 2022-12-05DOI: 10.14238/pi62.6.2022.367-72
I. Murni, Emmanuel Mareffcita Siagian, N. Nurnaningsih, Nadya Arafuri
Background Pulmonary hypertension carries significant morbidity and mortality in children. Early diagnosis and management may improve outcomes in children with pulmonary hypertension. Heart catheterization, a gold standard for diagnosing pulmonary hypertension, is an invasive procedure and not widely available. Echocardiography can be used as an alternative diagnostic tool for pulmonary hypertension. Objective To determine the diagnostic value of tricuspid regurgitation pressure gradient on echocardiography compared to heart catheterization to diagnose pulmonary hypertension in children. Methods This diagnostic test study was done with medical record data of children with acyanotic congenital heart disease who underwent cardiac catheterization and echocardiography procedures from January 2018 to December 2020 at Dr. Sardjito Hospital, Yogyakarta, Indonesia. Data were analyzed to obtain sensitivity, specificity, positive and negative predictive values, as well as positive and negative likelihood ratios. Results A total of 98 children with acyanotic congenital heart disease were included. The sensitivity and specificity of the tricuspid regurgitation pressure gradient to determine pulmonary artery pressure compared to heart catheterization were 64.4% and 54.5%, respectively. The positive likelihood ratio was 1.42. The pre-test and post-test probability of this study were 88.7% and 91.7%, respectively. Conclusion Tricuspid regurgitation pressure gradient measured using echocardiography has poor sensitivity and specificity to diagnose pulmonary hypertension.
{"title":"Tricuspid regurgitation pressure gradient to diagnose pulmonary hypertension: a diagnostic accuracy study","authors":"I. Murni, Emmanuel Mareffcita Siagian, N. Nurnaningsih, Nadya Arafuri","doi":"10.14238/pi62.6.2022.367-72","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.367-72","url":null,"abstract":"Background Pulmonary hypertension carries significant morbidity and mortality in children. Early diagnosis and management may improve outcomes in children with pulmonary hypertension. Heart catheterization, a gold standard for diagnosing pulmonary hypertension, is an invasive procedure and not widely available. Echocardiography can be used as an alternative diagnostic tool for pulmonary hypertension. \u0000Objective To determine the diagnostic value of tricuspid regurgitation pressure gradient on echocardiography compared to heart catheterization to diagnose pulmonary hypertension in children. \u0000Methods This diagnostic test study was done with medical record data of children with acyanotic congenital heart disease who underwent cardiac catheterization and echocardiography procedures from January 2018 to December 2020 at Dr. Sardjito Hospital, Yogyakarta, Indonesia. \u0000Data were analyzed to obtain sensitivity, specificity, positive and negative predictive values, as well as positive and negative likelihood ratios. \u0000Results A total of 98 children with acyanotic congenital heart disease were included. The sensitivity and specificity of the tricuspid regurgitation pressure gradient to determine pulmonary artery pressure compared to heart catheterization were 64.4% and 54.5%, respectively. The positive likelihood ratio was 1.42. The pre-test and post-test probability of this study were 88.7% and 91.7%, respectively. \u0000Conclusion Tricuspid regurgitation pressure gradient measured using echocardiography has poor sensitivity and specificity to diagnose pulmonary hypertension.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"47 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87052868","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：