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Objectives: To describe the incidence rate and clinical outcomes of intussusception in Australia in children aged <24 months prior to the use of rotavirus vaccines in Australia, and to explore associations between patient characteristics and outcomes in children with intussusception.

Introduction: Left ventricular hypertrophy (LVH) is the most common cardiac abnormality in chronic kidney disease (CKD). Changes in cardiac geometry and functions may occur in an early stage and worsen as CKD progresses. Recently, the role of fibroblast growth factor 23 (FGF23) is being highlighted and investigated in CKD-related cardiomyopathy. However, only a few studies have reviewed the utilization of FGF23 as a diagnostic biomarker in the pediatric CKD population. Purpose: This study aimed to identify the role of FGF23 as a biomarker in assessing cardiac changes in children with CKD. Patients and Methods: We conducted a cross-sectional study that involved children aged 2 to 18 years old with CKD stages 2 to 5D in Dr. Sardjito General Hospital, Yogyakarta, Indonesia. The level of FGF23 was measured using an immunometric enzyme-linked immunosorbent assay. LVMI, RWT, and left ventricular ejection fraction (LVEF) were assessed with echocardiography. Receiver-operating characteristic (ROC) analyses were conducted to assess the diagnostic performance of FGF23 in detecting LVH with impaired contractility. Results: A total of 43 children with CKD stages 2 to 5D were included, among whom the prevalence of LVH diagnosis was 95.35%. The area under the curve (AUC) of FGF23 to assess LVH and systolic dysfunction was 0.82 (95% CI 0.62-1.0), and the optimal cutoff point was 1413 RU/mL (sensitivity 80%, specificity 78.95%). The median concentration of FGF23 increased with the decreasing eGFR and the increasing LVMI although the systolic and diastolic functions were preserved. Conclusion: FGF23 might be used as an early biomarker to detect cardiac changes in pediatric CKD patients, particularly for LVH and impaired systolic function among children with CKD stage 2 and higher.

Obesity and overweight are considerable health problems with increasing prevalence among adolescents. In Indonesia, basic health research data from Riskesdas shows an increase in the prevalence of obesity in adolescents aged 13-15 y.o, from 2.6% in 2010 to 6.7% in 2013. This high prevalence of overweight and obesity is related to various factors. This study aimed to determine the factors associated with hypertension and obesity in adolescents. This study was conducted on an overweight population, obese, and super-obese adolescents aged 13-15 year in the Yogyakarta City, Indonesia. Demographic data included the history of breastfeeding, birth weight, gender, history of premature birth, lifestyle, and physical activity were gathered. Anthropometric data included the weight, height, and body mass index (BMI) were also measured and gathered. Hypertension was measured using a manual sphygmomanometer. The relationship was analyzed using Pearson chi-square and the risk value was demonstrated from the odds ratio (OR). A significant relationship between gender and diastolic hypertension was observed (OR= 2.4; 95%CI = 1.23 -5.09; p < 0.021). A significant difference related to the number of boy subjects between the 2 groups of overweight and obesity was also observed Compared with girls, boys had a higher risk of obesity (OR = 3.23). Other factors including breastfeeding, history of premature birth, low birth weight, and physical activity were not statistically significant between two groups in this study (p>0.05). in conclusion, there is a relationship between gender and diastolic hypertension incidence among obese adolescents. Boys are more at risk of obesity compared to girls.

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Long-term inflammation and recurrent skin infection in recessive dystrophic epidermolysis bullosa (RDEB) are associated with the presence of immunoglobulin A (IgA)-containing immune complexes in the glomerulus. Only eight pediatric RDEB cases with IgA nephropathy (IgAN) have been documented in English-language literature. Most RDEB patients with IgAN progress to kidney failure within 5 years of diagnosis, indicating that these patients may require more intensive early treatment compared to those with primary IgAN. However, diagnosing IgAN in RDEB cases with severe cutaneous manifestations can be challenging. Herein, we report a rare case of nephropathy in an 11-year-old boy with severe RDEB and a frameshift mutation on the <i>COL7A1</i> gene, which may manifest as kidney disorders. He presented with persistent hematuria and progressing proteinuria. A presumptive IgAN diagnosis was based on clinical features and increased IgA serum levels, as kidney biopsy was refused by his parents. Nephrotic-range proteinuria persisted despite initial steroid and lisinopril treatment. Monthly intravenous cyclophosphamide (IV CPA; 500 mg/m²) led to proteinuria remission and preservation of kidney function for 2 years posttreatment. We conclude that <i>COL7A1</i> mutations may result in extracutaneous manifestations, including kidney disorders. The association between IgA-containing immune complex deposits in the glomerulus and recurrent skin infection in RDEB may indicate IgAN, particularly when kidney biopsy is infeasible due to severe skin manifestations. In our case, positive results with IV CPA suggest further investigation is needed to explore its potential role in non-rapidly progressing IgAN in children with RDEB.

Preterm neonates are born with fewer functional nephrons, rendering them vulnerable to secondary insult. These insults are associated with acute kidney injury (AKI); thus, structural damage must be detected as early as possible. Urinary L-type fatty acid-binding protein (u-LFABP) has been proposed as a highly suitable kidney injury biomarker during prematurity. We aimed to analyze the use of POC u-LFABP in critically ill, very preterm neonates. This study was conducted at the neonatal intensive care unit (NICU), Dr. Cipto Mangunkusumo General Hospital, from November to December 2020. Baseline characteristics were recorded from electronic medical records. u-LFABP examination utilized stored urine samples from a previous study and was performed using a LFABP POC test kit. The proportion of abnormal u-LFABP (83.3%) was highest at 72 hours. Neonates with older gestational age (0–48 hours; p = 0.017 ) and higher birth weight (0–48 hours; p = 0.022 , 72 hours; p = 0.013 ) had normal u-LFABP levels. Neonates exposed to nephrotoxic agents showed higher proportion of abnormal u-LFABP (0–48 hours; p = 0.006 ). Longer invasive mechanical ventilation (IMV) period was observed in neonates with abnormal u-LFABP levels at 0–48 hours (7.44 ± 7.9 vs. 1.50 ± 2.9 days; p = 0.011 ). We found an association between complication rates and poorer disease outcome trends with abnormal u-LFABP; however, this relationship was not supported statistically. In conclusion, this study demonstrated that u-LFABP can be detected using bedside POC kit in critically ill very preterm neonates and those exposed to nephrotoxic agents may be at risk for kidney injury, confirmed by abnormal u-LFABP levels.