20 research outputs found
Effects of Duration of Breastfeeding During Infancy on Vascular Dysfunction in Adolescents
Get PDFAim: to investigate the effect of breastfeeding duration on vascular characteristics in adolescence. Methods: we conducted a retrospective cohort study on adolescents aged 15-18 years old. Breastfeeding duration was inquired using a questionnaire filled by parents and categorized into 0-12 months. Outcomes assessed were flow mediated dilation (FMD), carotid intima media thickness (CIMT), anthropometrics. Analysis was done using linear regression and MANOVA general linear model with cardiovascular risk factors as the dependent variables and breastfeeding duration as the independent variable with further adjustment for confounders. Results: 285 subjects aged 15-18 years were enrolled. Breastfeeding duration of 4-<6 months was associated with thinner CIMT and the effect was more prominent after adjustment for gender and postnatal tobacco exposure (mean difference=24.28 micrometer, p=0.045). No statistically significant association was found with FMD. Conclusion: breastfeeding duration of 4-<6 months is associated with thinner IMT and thus has a protective effect on the development of cardiovascular disease. However the association with FMD in adolescence is less clear.
Key words: breastfeeding duration, vascular structure and function, cardiovascular risk
Prevalence of patent ductus arteriosus in premature infants at the Neonatal Ward, Cipto Mangunkusumo Hospital, Jakarta
No full textBackground Patent ductus arterious (PDA) is one of the mostcommon congenital heart diseases encountered in preterm infants.The lower the birth weight and gestational age are, the higher theincidence of PDA is.Objectives To investigate the incidence of PDA in premature infantshospitalized in the neonatal wards of Cipto Mangunkusumo Hospitalusing echocardiography.Methods Preterm infants born between August and October 2003were included in this study. Clinical features were retrieved from medicalcharts. The first echocardiography was conducted on all of the preterminfants at the chronological age of 3 days. If PDA was detected,echocardiography was repeated at the chronological age of 6 days.Results During the 3-month period, sixty-five preterm infantsparticipated in this study and underwent echocardiography. In thefirst echocardiogram, the incidence rate of PDA was 32%. Atgestational age of less than 28 weeks, 1 of 2 infants had PDA. Of 3infants with birth weight of more than 1000 grams, 2 had PDA. Onthe second echocardiography, the incidence rate of PDA was 14%and mostly found in infants at gestational age of less than 28 weeks(8/9) and in those with birth weight of less than 1000 grams (7/9).All infants with RDS whose PDA was identified in the firstechocardiography proved to maintain their PDA in the secondechocardiography.Conclusion The incidence rate of PDA in preterm infants was14%. The lower the birth weight, the higher the incidence rate ofPDA. The presence of RDS is related to the delay in the closing ofthe arterial duct</jats:p
Akurasi Pulse Oksimetri Fingertip Dibandingkan Pulse Oksimetri Generasi Baru dalam Deteksi Dini Penyakit Jantung Bawaan Kritis pada Bayi baru Lahir: Penelitian Pendahuluan
No full textLatar belakang. Peningkatan morbiditas dan mortalitas bayi baru lahir dengan penyakit jantung bawaan kritis berkaitan dengan
diagnosis yang terlambat.
Tujuan. Mengetahui nilai diagnostik pulse oksimetri fingertip dibandingkan generasi baru untuk deteksi dini PJB kritis pada bayi
baru lahir.
Metode. Penelitian dilakukan di Ruang Rawat Gabung RSCM pada bayi bugar, usia gestasi 37 minggu, dan berusia 24-72 jam.
Oksimetri dilakukan di tangan kanan (preduktal) dan kaki (postduktal). Subjek dengan SpO2 3% antara tangan kanan
dan kaki diperiksa lebih lanjut.
Hasil. Pada 442 bayi, SpO2 preduktal kedua jenis pulse oksimetri bervariasi secara statistik namun tidak bermakna klinis. Tidak ada
subjek dengan hasil deteksi positif dan didiagnosis PJB kritis melalui pemeriksaan oksimetri.
Kesimpulan. Uji diagnostik pulse oksimetri fingertip dibandingkan generasi baru untuk deteksi dini PJB kritis pada bayi baru lahir
pada penelitian ini belum dapat dinilai
Risk Factors Affecting the Length of Improvement of Nutritional Status in Children with Congenital Heart Disease and Malnutrition
Get PDFBackground: To date, limited data are available regarding the factors that contribute to the delay of improvement in nutritional status as well as data regarding the optimal duration to improve malnutrition among children with congenital heart disease (CHD). Such data are important for pediatricians to fully optimize the nutritional status for those children prior to surgical procedure This study aims to identify those aforementioned factors in hope for better surgical outcome and quality of life of children with CHD.
Methods: This is a descriptive analytic study using retrospective cohort design to identify the factors that contribute to the delay of improvement in nutritional status among children with CHD. Variables such as the type of CHD, classification of CHD complexity, pulmonary hypertension, heart failure, corrective surgery, the route of nutrition access, pneumonia, diarrhea, special diets and patients undergoing routine control at the nutrition outpatient clinic were evaluated in this study.
Results: A total of 216 children with a diagnosis of CHD and weight-for-length z-score under -1 SD were included in this study. Based on multivariate analysis, there were two significant risk factors, which were the occurrence of diarrhea and consulting at nutrition outpatient clinic. The improvement in nutritional status in children with CHD who did not have diarrhea was faster than those with diarrhea (HR 1.94; 95% CI 1.10 – 3.47) (p value <0.025). Improvement in nutritional status of those children that underwent control at the nutrition outpatient clinic was faster than those who did not (HR 1.87; 95% CI 1.20 – 2.92) (p value <0.006).
Conclusion: Risk factors that significantly lengthen the duration of improvement in the nutritional status of CHD patients were the incidence of diarrhea and those who did not undergo control at the nutrition outpatient clinic
Comparison of complications between transcatheter and surgical ventricle septal defect closure: a single-center cohort study
No full textBACKGROUND Some ventricular septal defects (VSDs) require an interventional procedure for closure. Transcatheter and surgical closures of VSD have similar effectiveness, but transcatheter VSD closure is considered associated with less complication than surgical closure. This study aimed to compare mid-term or long-term complications of transcatheter and surgical VSD closures.
METHODS This was a retrospective cohort study compared the complication rates of transcatheter and surgical VSD closures performed in Cipto Mangunkusumo Hospital from January 1, 2010, to April 30, 2017, with 34 subjects in each group. The inclusion criteria were as follows: single lesion outlet perimembranous or doubly committed subarterial VSD, age 218 years, body weight >8 kg, and no arrhythmia. Electrocardiography and echocardiography were done to collect primary data. Other data were collected from medical records. Mid-term complications occurred 124 months after interventional closure. Long-term complications occurred 24 months after interventional closure. Complications were arrhythmia, valve regurgitation, and residual shunt. Data were analyzed by chi-square test.
RESULTS The rate of worsening valve regurgitation was higher in the transcatheter group than in the surgical group (16 versus 11, p = 0.322). The number of patients with residual shunts were similar between the transcatheter group and surgical group (5 versus 5; p = 1.000). Both complications were found in mid- and long-term. Arrhythmia as a long-term complication occurred in five and seven patients in the transcatheter and surgical groups, respectively (p = 0.752).
CONCLUSIONS Transcatheter and surgical VSD closures have similar mid or long-term complications
Cardiac Septal Defects in Children: Hemodynamics, Clinical Manifestations and Detection
Get PDFCardiac septal defect in children is one of the congenital heart defects characterized by atrial septal defects (ASD), ventricular septal defects (VSD) and defects in both atrial and ventricular septum (AVSD). The hemodynamic changes that occur are caused by a left to the right shunt. Differences in location, size of the defect and pulmonary vascular resistance make hemodynamic differences and clinical manifestations between the three types of cardiac septal defects. Detection of cardiac septal defects can be done by clinical examination by listening to the characteristic heart sounds and murmurs for each defect. However, clinical examination alone is often still difficult to determine the type of cardiac septal defect so that several supporting examinations such as photothorax, ECG, echocardiogram and cardiac catheterization need to be done to help establish the diagnosis
Automated image segmentation for cardiac septal defects based on contour region with convolutional neural networks: A preliminary study
No full textEchocardiogram examination is important for diagnosing cardiac septal defects. With the development of AI-based technology, an echocardiogram examination previously performed manually by cardiologists can be done automatically. Automatic segmentation of cardiac septal defects can help a physician to make an initial diagnosis before referring a pediatric cardiologist for further treatment. In previous studies, automatic object segmentation using convolutional neural networks (CNNs) was one of the DL applications that have been developed for cardiac abnormalities. In this study, we propose a CNN-based U-Net architecture to automatically segment the cardiac chamber to detect abnormalities (holes) in the heart septum. In this study, echocardiogram examinations were performed on atrial septal defects (ASDs), ventricular septal defects (VSDs), atrioventricular septal defects (AVSDs), and normal hearts with patients undergoing echocardiogram examination at Moh Hoesin Hospital in Palembang. The results show that even for the relatively small number of datasets, the proposed technique can produce superior performance in the detection of the cardiac septal defects. Using the proposed segmentation model for four classes produces a pixel accuracy of 99.15%, mean intersection over union (IoU) of 94.69%, mean accuracy of 97.73%, sensitivity of 96.02%, and F1 score of 94.88%, respectively. The plots of the loss and accuracy curve show that all the errors were small, with accuracy rates reaching 99.05%, 98.62%, 99.39%, and 98.97% for ASD, VSD, AVSD, and normal heart, respectively. The comparison accuracy of contour prediction for U-Net was 99.01%, while V-Net was 93.70%. This shows that the U-Net has better accuracy than the V-Net model architecture. It can be proven that the architecture of CNNs has been successful in segmenting the cardiac chamber to detect defects in the heart septum and support the work of cardiologists
Left ventricular functions and mass of the adolescents and young adults with thalassemia major: An echocardiography study
No full textBackground Thalassemia major (TM) is a transfusion-depen-dent disease. Multiple transfusions cause an accumulation of ironin the body. On the heart, iron can induce cardiomyopathy, theleading cause of death in TM.Objective To evaluate left ventricular functions and mass amongadolescents and young adults with TM.Methods A cross-sectional study was conducted on 58 patientswith TM in Cipto Mangunkusumo Hospital, Jakarta. Hematologicaldata was collected from medical record. Left ventricular systolic func-tions (EF, FS), diastolic functions (A, E, E/A ratio, IVRT), and mass(LVDDi, LVDSi, LVMi) were detected using an echocardiographySonos 4500. T test, linier regression, and multiple regression analy-sis were performed.Results Out of 32 TM patients, 30 were enrolled to study. Leftventricular systolic and diastolic functions of TM patients were lowerthan those of the control and statistically significant [EF 66.1% (SD4.9) and 71.6% (SD 5.6); P<0.0001, FS 36.0% (SD 3.7) and 39.8%(SD 5.5); P=0.003, E/A 2.14 (SD 0.4) and 1.83 (SD 0.3); P=0.002,respectively]. Left ventricular mass of TM patients was greater thanthat of control, and also statistically significant [LVMi 111.1 g/m 2(SD 30.8) and 75.4 g/m 2 (SD 14.5); P<0.0001, respectively]. Linierand multiple regression analysis showed significant and powerfulcorrelation between left ventricular diastolic functions (E/A ratio)and serum ferritin concentration (r=0.71; P<0.0001).Conclusion Left ventricular functions and mass of adolescentsand young adults with TM show abnormalities. The higher the con-centration of ferritin serum is, the more likely for TM patient to suf-fer from diastolic abnormality</jats:p
ICAM-1 and S100β plasma value in children with sepsis
Get PDFICAM-1 release during sepsis is perceived to be related to brain injury. Whereas S100β has been known as one of brain injury markers.To measure mean value of ICAM-1, S100β, to find correlation between ICAM-1 and Glasgow Coma Scale (GCS), between S100β and GCS, also ICAM-1 and S100β.Analytical cross sectional study in 34 sepsis children, measurement of ICAM-1 and S100β plasma levels within day 1 and 3 since diagnosis of sepsis.Median level of ICAM-1 day one 548,1 (158,6 – 1256,1) ng/mL and day three 596,5 (185,5 – 1264,5) ng/mL (p=0,164). S100β median is significantly higher in severe than mild sepsis (p=0,008 dan p=0,021). On third day S100β was negatively related to GCS (r= - 0,452; p=0,003). The correlation observed between ICAM-1 and S100β on day one was r=0,146 (p=0,409) while on third day was r=0,184 (p=0,298).The prevalence of encephalopathy sepsis is 5.9%, Median ICAM-1 is higher on day three. Median of S100β is higher in severe than mild sepsis.There is no correlation between ICAM-1 and GCS in both sepsis. There was negative correlation between S100β and GCS on 3rd day of sepsis. No correlation between ICAM-1 and S100β on both measurement days
The role of physical activity on cardiovascular risk factors in adolescents
No full textBackground Cardiovascular diseases remain the leading cause of death worldwide. Atherosclerotic process increases rapidly during adolescence. Physical activity is considered important in this period to modify cardiovascular risk factors, thus preventing disease in the future.Objective To determine whether different physical activity status in adolescence can influence body mass index (BMBMI), waist-to-hip ratio, blood pressure (BP), and blood lipid profile.Methods This was a cross-sectional descriptive study, conducted from December 2009 to January 2010. Adolescents who fulfilled the study criteria were classified into high and low physical activity category. Further examination including body mass index, waist-to-hip ratio, blood pressure, and blood lipid profile were performed.Results Adolescents with high physical activity had higher, but statistically insignificant, BMBMI compared to adolescents in the P=0.493] and significantly lower waist-to-hip ratio [0.80 (range 0.73-0.9) vs.. 0.82 (range 0.7-0.9), P=0.019]. Difference in BP was not statistically significant between both groups [diastolic BP (70 (range 60-90) mmHg vs. 70 (range 60-90) mmHg, P=0.148; systolic BP 100 (range 90-130) mmHg vs. 100 (range 90-140) mmHg, P=0.228)]. Blood lipid examination in the high activity group showed significantly higher HDL cholesterol and lower triglyceride compared to the low activity group [HDL 59.8 (SD 11.8) mg/dL vs. 54.7 (SD 8.9) mg/dL; p=0.044; triglyceride: 60 (range 32-203) mmHg vs. 82 (range 37-198) mmHg, P=0.014]. Total and LDL cholesterol [total cholesterol 169.8 (SD 28.6) mmHg vs. 181.2 (SD 30.8) mmHg, P=0.107; LDL 103.6 (SD 26.8) mmHg vs. 114.1 (SD 27.3) mmHg, P=0.100] were lower in the high activity group but not statistically different in both groups.Conclusions Adolescents with high physical activity show less cardiovascular risk factors compared to those in the low physical activity group.</jats:p
