Latar belakang. Pada anak dengan defek septum ventrikel (DSV), terjadi peningkatan aliran darah ke paru. Semakin besar DSV, semakin meningkat aliran darah ke paru maka risiko infeksi saluran pernafasan akut dan gagal jantung meningkat dan menganggu fungsi paru. Fungsi paru yang baik penting untuk pemeliharaan suplai oksigen saat sebelum dan setelah dilakukan operasi. Spirometri merupakan alat yang penting dan praktis dalam menilai fungsi paru. Perbandingan FEV1/FVC digunakan untuk mendiagnosis dan membedakan antara penyakit paru obstruktif dan restriktif.Tujuan. Membuktikan adanya hubungan antara besarnya DSV, flow ratio, klasifikasi gagal jantung, frekuensi infeksi respiratori akut (IRA), dan status gizi dengan fungsi paru.Metode. Dilakukan penelitian observasional dengan pendekatan cross-sectional di RS dr. Kariadi dari bulan September 2011 sampai dengan Desember 2012. Subjek anak dengan DSV yang belum dilakukan operasi, umur 5-14 tahun yang mendapat terapi di instalasi rawat jalan RS dr. Kariadi. Dilakukan ekokardiografi untuk mengukur diameter DSV dan flow ratio (Qp/Qs) dan spirometri untuk menilai fungsi paru melalui pengukuran (FEV1/FVC). Analisis statistik dengan uji korelasi Spearman dan uji Fisher’s Exact.Hasil. Subjek terdiri atas 20 anak dengan DSV (65% perempuan). Rerata diameter DSV 12,32 mm (SB 9,18), rerata dari flow ratio 2,63 (SB 0,92), rerata frekuensi IRA 4,60 kali (SB 2,98). Rerata FEV1/FVC adalah 94,1% (SB 9,82). Ukuran DSV besar, flow ratio yang tinggi, dan seringnya IRA mempunyai risiko tinggi untuk terjadinya gangguan fungsi paru restriktif, secara berturut-turut dengan RP=1,5 (p=0,038), RP=1,8 (p=0,009), RP=1,5 (p=0,038). Status gizi berhubungan sedang dengan fungsi paru (r=0,604, p=0,005).Kesimpulan. DSV besar, flow ratio, frekuensi IRA, dan status gizi berhubungan dengan fungsi paru.
Brebes is an agricultural village in north coastal area of Central Java that is exposed to organophosphate pesticides. Organophosphate could cause mechanical damage of artery such as increasing the stiffness and leading to arteriosclerosis in early life. Aortic (Ao) elasticity profiles of children who are living in those polluted area have never been studied. The aim of study was to determine Ao wall stiffness and distensibility in children living in Brebes. A cross sectional study was conducted in fifty students aged 9-12 years (mean 9.24 SD 0.69), male 30 and 20 female, who were living in Brebes. Ascending Ao distensibillity and stiffness were obtained on M-mode using Logic E echocardiography. Mean value of three times measurement was presented and compared with standard for healthy children according to the age. Mean and median of Ao-distensibility were 98.7 (SD 55.08) and 90.8 (13.98-224.55) [normal 97.1 (SD 47.6); 85.7 (22.6-368.5)]; Ao-stiffness index were 2.2 (SD 0.55) and 2.1 (1.28-4.06) [1.18 (SD 0.57); 1.05 (0.24-3.69)] respectively. Ao distensibility of subjects showed 16% lower, 62% normal and 20% higher than the mean of standard value. Ao stiffness index of subjects was 16% normal and 84% higher than standard. After adjusted with BSA, 78% of subject's Ao distensibility/BSA was normal, 96% has higher Ao stiffness index/BSA than mean standard value. This study found higher Ao-stiffness index among children living in organophosphate exposure area, despite of normal Ao distensibility.
Down syndrome (DS) or trisomy 21, causes overexpression of genes in most affected organs, including congenital heart disease (CHD). CHD is found in 40-60% of people with DS, with a high mortality rate in early life.Clinical signs and symptoms often found are essential indicators of early diagnosis of CHD. This study aimed todetermine the clinical characteristics of DS children with and without CHD. This study was a retrospective study.The study was conducted on August until October 2019. We took data from the inpatient and outpatient medicalrecords database for the years 2017-2019 in Dr. Kariadi Hospital, Semarang, Indonesia. Some informationincludes clinical signs and symptoms, nutritional status, comorbidities, and frequency of hospitalization in amonth were collected. A total of 66 patients were diagnosed with DS, consisting of 44 DS patients with CHDand 22 DS patients without CHD. There were no differences in nutritional status, interrupted breastfeeding, chestretraction, respiratory rate, thyroid disorder, hearing abnormalities, acute otitis media, and obstructive sleepapnea in both groups (p> 0.05). There were significant differences in the clinical characteristics of cyanosis(p=0.005), heart murmur (p=<0.001), and frequency of acute respiratory tract infection in a year (p=<0.001), andfrequency of hospitalization per month (p=0.039) in DS children with and without CHD. In conclusion, we foundsignificant difference in clinical characteristic in DS children with and without CHD.
Latar belakang : Obesitas telah menjadi epidemi global karena prevalensi dan komplikasinya baik pada anak maupun dewasa. Meskipun aterosklerosis telah diketahui dimulai pada masa anak, tetapi sampai sekarang belum ada penanda aterosklerosis dini khususnya pada anak. Tujuan penelitian ini adalah mencari hubungan antara kadar lipid darah dengan hsCRP sebagai penanda dini aterosklerosis pada anak. Metode : Desain penelitian adalah belah lintang. Tempat penelitan di SMP Domenico Savio, salah satu SMP di Semarang, yang telah diketahui tinggi angka obesitasnya. Dinilai indeks massa tubuh (IMT) dan persentase lemak tubuh pada murid usia 12-14 tahun, serta kadar lipid darah (kolesterol total, LDL, HDL serta trigliserida) dari darah puasa. Sampel dipilih secara acak, dihitung dengan rumus untuk uji korelasi, dibutuhkan sampel 35 anak obesitas, dan diambil 35 anak normal sebagai pembanding, maka total subyek penelitian minimal adalah 70 orang. Hasil : Terdapat perbedaan kadar trigliserid (95%CI;0,13-0,26) dan hsCRP (95%CI;0,37-0,87) pada kelompok obesitas dan kontrol. Pada seluruh subyek, hsCRP berhubungan sedang dengan IMT (r=0,445;p< 0,05) dan persen lemak tubuh (r=0,44;p<0,05) serta hubungan lemah antara kadar HDL dan hsCRP (r=-0,227; p<0,05). Simpulan : Kadar hsCRP akan meningkat bila terjadi peningkatan IMT dan persentase lemak tubuh, sedangkan kadar HDL kolesterol bersifat protektif terhadap peningkatan hsCRP
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