Correlation of clinical and echo-cardiographic scores with blood “Brain natriuretic peptide” in paediatric patients with heart failure

Background: Recently brain natriuretic peptide (BNP) level has been introduced as a screening test for congestive heart failure (CHF) in children. The current CHF assessment scores are not satisfactory as they use a large number of variables.Objective: To evaluate two CHF scores: a modified clinical score and an echocardiographic score and compare them to BNP in paediatric patients.Design: Prospective, hospital based study.Setting: Two paediatric cardiac referral centres in Khartoum from April to July 2010.Subjects: All patients one month to 18 years of age with the clinical diagnosis of CHF were included.Results: Sixty seven patients were enrolled, 39 (58%) had congenital heart disease (CHD), 27 (32%) had rheumatic heart disease (RHD), and seven (10%) had dilated cardiomyopathy (DCM).Twenty four younger children (88%) and 29 older children (85%) had a high clinical score (severe CHF). Twenty one out of 23 younger children with high echo score (91%) had a high clinical score as well (p-value 0.001). In patients with RHD (all with a high clinical score), 81 % had a high echo score. (p-value 0.001). All younger children with a high clinical score (n=24) had a high level of BNP (p-value 0.00). In older children with a high clinical score 28 out of 29 (96%) had a high BNP level (p-value 0.00). Of patients with RHD and a high echo score (21), 16 (76.2%) patients had high BNP level and five (23.8%) had low level of BNP. All patients with DCM had high echo score and all of them had high levels of BNP (100%) (p-value.0.00).Conclusion: We tested clinical and echo scores and proved their value in assessment of CHF in children. The scores correlated well with BNP level. We recommend the use of these scores as well as BNP level in clinical practice

STUDI FENOMENOLOGIS TENTANG PENERIMAAN ORANGTUA TERHADAP ANAK AUTIS DI SLB NEGERI SEMARANG

Autisme merupakan salah satu gangguan perkembangan neurologis yang muncul pada saat anak mencapai usia 3 tahun. Orangtua yang mempunyai anak autis, pada umumnya akan mengalami berbagai macam perasaan, antara lain perasaan menyangkal, menangis, stress, dan sedih. Keberadaan anak autis dalam suatu keluarga dapat memberikan pengaruh pada sikap penerimaan orang tua terhadap anaknya yang autis.Penelitian ini bertujuan untuk mengetahui tentang pengalaman orangtua dalam menerima kondisi anaknya yang autis di Sekolah Luar Biasa (SLB) Negeri Semarang. Penelitian ini merupakan jenis penelitian kualitatif dengan pendekatan fenomenologis, yang menggunakan metode observasi dan wawancara mendalam. Populasi yang diteliti yakni seluruh orangtua yang memiliki anak autis di SLB Negeri Semarang dan menggunakan sampel sebanyak 6 orangtua yang diambil secara Purposive Sampel.Hasil penelitian menunjukkan bahwa pengalaman orangtua dalam menerima anaknya yang autis ditunjukkan dari cara mereka (orangtua) merawat anaknya layaknya anak anak normal pada umumnya, seperti memandikan, menyuapi, menemani belajar, serta mengajak anak bermain. Adapun kendala mereka (orangtua) dalam merawat anaknya yang autis, antara lain perilaku hiperaktif anak yang kadang tidak dapat dikendalikan, terbatasnya sarana terapi, serta kondisi financial keluarga yang kurang mendukung. Oleh karena itu, untuk mengatasi permasalahan dalam merawat anaknya yang autis tersebut, orangtua lebih memperhatikan diit (diit khusus anak autis) untuk mengurangi perilaku hiperaktif anak dan orangtua akan selalu berpikir secara kreatif dalam menciptakan sesuatu yang baru untuk mengoptimalkan upaya penyembuhan sebagai bentuk kasih sayang dan perhatian mereka terhadap anaknya yang autis.Kata Kunci : Autisme, Orangtua, Penerimaa

Perbandingan Keefektifan Kompres Tepid Sponge Dan Kompres Air Hangat Terhadap Penurunan Suhu Tubuh Pada Anak Demam Tifoid Dengan Hipertermi Di Rsud Sukoharjo

Typhoid fever is one of the diseases of the digestive that is caused by the salmonella typhi and characterized by a rise in body temperature or fever. Compress is one of the measures to decrease the production of heat and heat increase spending. The purpose of this research is viewed comparison of effectiveness between tepid sponge compress and warm water compress against a decrease in body temperature. Types of quantitative research, research design used was a quasi experimental design with pretest-posttest two group treatment. Sample research amounted to 38 respondents, then divided in two groups of treatment tepid sponge compress and warm water compress so that each group of 19 respondents, treatment was given for 15 minutes. Statistical analysis using the T-Test test : Paired Sample T-Test to analyze the pre-test and post-test both treatment groups and Independent Sample T-Test to analyze the effectiveness of the comparison between the two treatment groups. Results Paired Sample T-Test, the significant value or p-value of tepid sponge compress for 0.000, the mean pre-test 38.6110c and post-test 36.8890c or decreased body temperature 1.720c and the significant value or p-value of warm water compress for 0.000, the mean pre-test 38.5000c and post-test 37.3790c or decreased body temperature 1.120c. Concluded both techniques are effective compress against a decrease in body temperature, but tepid sponge compress is more effective to decrease body temperature. The result of Independent Sample T-Test, the significant value or p-value of 0.001. Statistical analysis has shown no significant effectiveness comparison between tepid sponge compress and warm water compress against the drop in body temperature the children with hyperthermia typhoid fever at RSUD Sukoharjo. Key Word : Tepid Sponge Compress And Warm Water Compress, Body Temperature, Typhoid Fever

Pengembangan kit diagnostik dengan biomarker ESAT-6 dan AG85A ebagai alat deteksi dini penyakit tuberkulosis

Tujuan jangka panjang penelitian ini sebagai kontrol yang efektif dalam pemberantasan penyakit Tuberkulosis dengan target khusus yang ingin dicapai dapat menekan tingkat morbiditas dan mortalitas kejadian penyakit Tuberkulosis di Indonesia. Tujuan khususnya memperbanyak antigen yang dapat menirnbulkan respon imun spesiftk seluler (ESA T6 dan Ag85A), sehingga mampu mendeteksi penyakit Tuberkulosis paru, penyakit Tuberkulosis paru dengan terapi, penyakit Tuberkulosis ekstrapulmonal. Metode yang akan digunakan, ekstraksi DNA dari bakteri M tuberculosis H3 7Rv dan M tuberculosis spesifik Indonesia. PCR dilakukan dengan menggunakan oligonukleotida primer gen spesifik dan produk PCR dimasukkan ke dalam vektor pTZ57R!T dan ditransfer ke Escherichia coli DH5a untuk menghasilkan antigen rekombinan Ag85A dan ESA T6 (Tahun Pertama). Selanjutnya dilakukan Ekspresi pada vector E. coli BL-21 dan dimumikan dengan HPLC. Hasil ekspresi dipuriftkasi untuk uj i imunogenitas sehingga mendapatkan antigen spesiftk. Selanjutnya dilakukan proses hibridoma untuk menghasilkan antibodi monoklonal secara kultur sel. Kultur sel akan menghasilkan Anti-Ag85A dan Anti-Esat6 untuk dijadikan biomarker dan kit diagnostik. Kit ini dapat mendeteksi dini antigen bakteri M tuberculosis pada manusia terinfeksi M tuberculosis dengan cepat, spesifik, sensitif, murah, dan mudah digunakan

Two-Year Outcomes After Minimally Invasive Surfactant Therapy in Preterm Infants: Follow-Up of the OPTIMIST-A Randomized Clinical Trial

Importance: The long-term effects of surfactant administration via a thin catheter (minimally invasive surfactant therapy [MIST]) in preterm infants with respiratory distress syndrome remain to be definitively clarified. / Objective: To examine the effect of MIST on death or neurodevelopmental disability (NDD) at 2 years' corrected age. / Design, Setting, and Participants: Follow-up study of a randomized clinical trial with blinding of clinicians and outcome assessors conducted in 33 tertiary-level neonatal intensive care units in 11 countries. The trial included 486 infants with a gestational age of 25 to 28 weeks supported with continuous positive airway pressure (CPAP). Collection of follow-up data at 2 years' corrected age was completed on December 9, 2022. / Interventions: Infants assigned to MIST (n = 242) received exogenous surfactant (200 mg/kg poractant alfa) via a thin catheter; those assigned to the control group (n = 244) received sham treatment. / Main Outcomes and Measures: The key secondary outcome of death or moderate to severe NDD was assessed at 2 years' corrected age. Other secondary outcomes included components of this composite outcome, as well as hospitalizations for respiratory illness and parent-reported wheezing or breathing difficulty in the first 2 years. / Results: Among the 486 infants randomized, 453 had follow-up data available (median gestation, 27.3 weeks; 228 females [50.3%]); data on the key secondary outcome were available in 434 infants. Death or NDD occurred in 78 infants (36.3%) in the MIST group and 79 (36.1%) in the control group (risk difference, 0% [95% CI, -7.6% to 7.7%]; relative risk [RR], 1.0 [95% CI, 0.81-1.24]); components of this outcome did not differ significantly between groups. Secondary respiratory outcomes favored the MIST group. Hospitalization with respiratory illness occurred in 49 infants (25.1%) in the MIST group vs 78 (38.2%) in the control group (RR, 0.66 [95% CI, 0.54-0.81]) and parent-reported wheezing or breathing difficulty in 73 (40.6%) vs 104 (53.6%), respectively (RR, 0.76 [95% CI, 0.63-0.90]). / Conclusions and Relevance: In this follow-up study of a randomized clinical trial of preterm infants with respiratory distress syndrome supported with CPAP, MIST compared with sham treatment did not reduce the incidence of death or NDD by 2 years of age. However, infants who received MIST had lower rates of adverse respiratory outcomes during their first 2 years of life. / Trial Registration: anzctr.org.au Identifier: ACTRN12611000916943

Age-related changes to motor synergies in multi-joint and multi-finger manipulative skills: a meta-analysis

Purpose The aim of the current meta-analysis was to examine the extent to which there are differences in upper extremity motor synergies across different age groups in manipulative tasks. Methods The studies that used the uncontrolled manifold method to examine the effect of age on motor synergies in multijoint and multi-finger tasks were selected. Sixteen relevant studies from 1154 articles were selected for the meta-analysis—4 and 12 studies considered multi-joint kinematics and multi-finger kinetic tasks respectively. Results The results of the meta-analysis suggested reduced strength of synergies in multi-finger task in older adults, but this was not the case for synergies in multi-joint task. Part of this age-related difference in finger function is related to the increased variability in total force in grasping tasks. However, reductions in the strength of multi-finger synergies in hand functions following ageing appear to depend on the characteristics of the task. Conclusions These findings indicate that the cooperation among fingers to stabilise the total required force to apply for grasping and other fine motor skills is less efficient in older adults that might affect the quality of manipulative tasks

Advocacy at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery

The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) will be held in Washington DC, USA, from Saturday, 26 August, 2023 to Friday, 1 September, 2023, inclusive. The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery will be the largest and most comprehensive scientific meeting dedicated to paediatric and congenital cardiac care ever held. At the time of the writing of this manuscript, The Eighth World Congress of Pediatric Cardiology and Cardiac Surgery has 5,037 registered attendees (and rising) from 117 countries, a truly diverse and international faculty of over 925 individuals from 89 countries, over 2,000 individual abstracts and poster presenters from 101 countries, and a Best Abstract Competition featuring 153 oral abstracts from 34 countries. For information about the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery, please visit the following website: [www.WCPCCS2023.org]. The purpose of this manuscript is to review the activities related to global health and advocacy that will occur at the Eighth World Congress of Pediatric Cardiology and Cardiac Surgery. Acknowledging the need for urgent change, we wanted to take the opportunity to bring a common voice to the global community and issue the Washington DC WCPCCS Call to Action on Addressing the Global Burden of Pediatric and Congenital Heart Diseases. A copy of this Washington DC WCPCCS Call to Action is provided in the Appendix of this manuscript. This Washington DC WCPCCS Call to Action is an initiative aimed at increasing awareness of the global burden, promoting the development of sustainable care systems, and improving access to high quality and equitable healthcare for children with heart disease as well as adults with congenital heart disease worldwide

Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study

BACKGROUND: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. METHODS: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. RESULTS: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. CONCLUSIONS: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future

Dasar - Dasar Dokumentasi Keperawatan

v, 195 hlm.; 15 x 21.5 c