Background Daunorubicin is a chemotherapy drug for leukemia treatment, but it can cause cardiotoxicity. When heart damage occurs, myocardial sarcomeres release troponin-I, which could potentially be useful as a cardiotoxicity biomarker. Objective To assess for possible correlations between troponin-I and echocardiographic parameters of left ventricular function after administration of daunorubicin in children with high-risk acute lymphoblastic leukemia (ALL). Methods This cross-sectional study on 37 children with high-risk ALL was performed from July 2017 to December 2018, in Padang, West Sumatera. The left ventricular systolic function parameters measured were ejection fraction (EF) and fractional shortening (FS); the left ventricular diastolic function parameter was E/A ratio. Troponin-I measurements and echocardiography were performed after daunorubicin treatment at the end of induction phase chemotherapy. Pearson’s correlation test was used to analyze for a correlation between troponin-I and echocardiographic parameters. Results Subjects had a mean age of 6.27 (SD 4.43) years, and males comprised 56.8%. Subjects’ mean troponin-I concentration was 5.49 (SD 0.86) ng/mL, and mean EF, FS, and E/A values were 65 (SD 5) %, 36 (SD 4) %, and 1.52 (SD 0.56), respectively. Troponin-I was not significantly correlated with EF (r=0.062; P=0.715) or FS (r=0.309; P=0.172). However, there was a weak, significant negative correlation between troponin-I and E/A ratio (r=-0.383; P=0.019). Conclusion Troponin-I level has no significant correlations with the echocardiographic parameters of left ventricular systolic function. However, there is a weak significant negative correlation between troponin-I level and the left ventricular diastolic parameter of E/A ratio.
AbstrakGizi buruk terjadi akibat gangguan gizi kronik dan menyebabkan gangguan pertumbuhan yang berpengaruh terhadap kesehatan, kecerdasan dan produktivitas saat beranjak dewasa. Kecukupan nutrisi remaja sangat penting agar selaras dengan pacu tumbuh dan merupakan investasi untuk generasi yang lebih baik. Short bowel syndrome merupakan kondisi gangguan malabsorpsi akibat reseksi usus halus ekstensif dan memerlukan nutrisi parenteral > 42 hari setelah reseksi usus. Pengamatan jangka panjang dilakukan pada remaja dengan gizi buruk tipe marasmik kwashiorkor dengan short bowel syndrome et causa perforasi yeyunum dan anemia defisiensi besi. Pasien selalu mengeluh nyeri perut bila mendapat makanan padat, muntah, diare, penurunan nafsu makan dan berat badan dengan status gizi buruk. Penelusuran etiologi didapatkan perforasi yeyunum sehingga dilakukan yeyunostomi dan prosedur Santulli. Selama rawatan pasien mengalami short bowel syndrome dan ditatalaksana dengan kombinasi nutrisi parenteral dan enteral peroral. Akhir pemantauan berat badan menjadi 37 kg dengan kesan gizi baik.Penatalaksanaan yang tepat pada penderita gizi buruk dengan short bowel syndrome et causa perforasi yeyunum memberikan hasil akhir yang baik. Kata kunci: gizi buruk, short bowel syndrome, perforasi yeyunum Abstract Malnutrition occurs due to chronic nutritional disorder, and leads to growth disorders affecting health, intelligence and productivity. Adequacy of nutrition during adolescence is very important to keep the growth spur and an investment for a better generation. Short bowel syndrome is a malabsorption disorder due to extensive intestinal resection and requires parenteral nutrition > 42 days after bowel resection. Long-term observation was performed in an adolescent girl with marasmic-kwashiorkor-type malnutrition with short bowel syndrome et causa yeyunum perforation and iron deficiency anemia. Patient's complained of having abdominal pain during eating solid food, accompanied by vomiting, diarrhea, decreased of appetite and body weight with malnutrition status. From the etiologic search, yeyunum perforation was obtained so the yeyunostomi and Santulli's procedure were performed. During treatment the patient had short bowel syndrome and was treated with combination of parenteral and enteral nutritions. By the end of the monitoring, body weight was 37 kg with good nutritional status. Proper management of malnourished patients with short bowel syndrome et causa perforation yeyunum gives a good result.
Gizi buruk terjadi akibat gangguan gizi kronik dan menyebabkan gangguan pertumbuhan yang berpengaruh terhadap kesehatan, kecerdasan dan produktivitas saat beranjak dewasa. Kecukupan nutrisi remaja sangat penting agar selaras dengan pacu tumbuh dan merupakan investasi untuk generasi yang lebih baik. Short bowel syndrome merupakan kondisi gangguan malabsorpsi akibat reseksi usus halus ekstensif dan memerlukan nutrisi parenteral > 42 hari setelah reseksi usus. Pengamatan jangka panjang dilakukan pada remaja dengan gizi buruk tipe marasmik kwashiorkor dengan short bowel syndrome et causa perforasi yeyunum dan anemia defisiensi besi. Pasien selalu mengeluh nyeri perut bila mendapat makanan padat, muntah, diare, penurunan nafsu makan dan berat badan dengan status gizi buruk. Penelusuran etiologi didapatkan perforasi yeyunum sehingga dilakukan yeyunostomi dan prosedur Santulli. Selama rawatan pasien mengalami short bowel syndrome dan ditatalaksana dengan kombinasi nutrisi parenteral dan enteral peroral. Akhir pemantauan berat badan menjadi 37 kg dengan kesan gizi baik. Penatalaksanaan yang tepat pada penderita gizi buruk dengan short bowel syndrome et causa perforasi yeyunum memberikan hasil akhir yang baik.
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