scholarly journals Determination of urinary d-/l-arabinitol ratios as a biomarker for invasive candidiasis in children with cardiac diseases

2010 ◽  
Vol 59 (12) ◽  
pp. 1490-1496 ◽  
Author(s):  
Teresa J. Stradomska ◽  
Dorota Sobielarska ◽  
Zbigniew Mielniczuk ◽  
Dorota Jagiełłowicz ◽  
Małgorzata Syczewska ◽  
...  

A non-invasive, non-culture-based method of determining urinary d-/l-arabinitol (d-/l-ARA) ratios was investigated as a tool for the diagnosis of invasive candidiasis in nosocomial paediatric infection cases. The study encompassed 138 children aged 4 days to 16 years (mean±sd=1.6±4.2 years) with congenital heart defects (91.4 %) or with rhythm disorders or circulatory failure (8.6 %). ARA enantiomers were detected by GC using an electron capture detector. Positive d-/l-ARA ratios were found for 11/11 patients with proven candidiasis and 17/19 patients with clinically suspected invasive candidiasis. Thirty children were undergoing antifungal chemotherapy. d-/l-ARA ratios (mean±sd) were 2.601±0.544 in hospitalized cardiac patients without fungal infection and 5.120±1.253 in those receiving antifungal therapy (P<0.001). The sensitivity of the method was 100 %, the specificity 97.2 %, the positive predictive value was 78.6 % and the negative predictive value was 100 %.

2017 ◽  
Vol 4 (3) ◽  
pp. 832
Author(s):  
Krithika Damodar Shenoy ◽  
Suchetha S. Rao

Background: Critical congenital heart defects (CCHD) are associated with poor patient outcome due to delay in diagnosis. Clinical examination alone has low positive predictive value (PPV). Pulse oximetry examination is suggested as supplemental screening tool. Aim of this study was to screen term neonates for CCHD by clinical and pulse oximetry evaluations and estimate their PPV separately and combined.Methods:Cross-sectional study of 278 term neonates weighing ≥2500g excluding those with antenatal diagnosis of congenital heart defects and/or requiring intensive care. Sample size calculated using EpiInfo version 7 taking 20,000 as population size, 7% expected frequency, 5% confidence limits and 99.9% confidence level. Ethical clearance and informed consent obtained. Clinical examination was performed within 24 hours of life followed by pre-ductal and post-ductal oxygen saturation (SpO2) recording, using standardized hand-held probe, between 24-48 hours. Neonates categorized as screen positive or negative based on an adapted algorithm. Screen positives were confirmed by echocardiography. SPSS version 16 was used for statistical analysis.Results: Mean age at clinical examination was 7.72 ± 0.32 hours during which none screened positive. Mean age at SpO2 screening was 31.93 ± 0.32 hours and a single non-syndromic, acyanotic male newborn, weighing 2550g screened positive. He was found to have severe pulmonary outflow obstruction, with ductus-dependent flow on echocardiography. PPV for pulse oximetry screening alone was 100%.Conclusions:Ductus dependent lesions missed on clinical examination may be picked up by pulse oximetry screening. Echocardiography may be used selectively to confirm diagnosis on screen positive. 


2017 ◽  
Vol 21 (1) ◽  
pp. 117 ◽  
Author(s):  
E. V. Saperova ◽  
I. V. Vakhlova

<p class="a">Natriuretic peptides (NUP) are peptide hormones secreted by cardiomyocytes in response to a volume overload of the heart. Emphasis in the article is placed on the history of NUP discovery, their chemical structure and pathophysiological mechanisms of action. The data on determination of NUP reference values in children with cardiac pathologies are analyzed. A NUP clinical significance in early diagnosis of heart failure in children, including those with congenital heart defects is shown. Also considered is NUP dynamics after surgical correction of congenital heart defects. A conclusion is drawn that NUP play an important prognostic role in evaluating early and late postoperative periods and disease outcomes on a whole.</p><p align="JUSTIFY">Received 11 October 2016. Accepted 22 December 2016.</p><p align="JUSTIFY"><strong>Funding: </strong>The study had no sponsorship.</p><p align="JUSTIFY"><strong>Conflict of interest: </strong>The authors declare no conflict of interest.</p><p align="JUSTIFY"><strong>Author contributions</strong></p><p align="JUSTIFY">All authors contributed equally at all stages of the research.</p>


2021 ◽  
Vol 132 ◽  
pp. S319-S320
Author(s):  
Mark Hajjar ◽  
Pooja Mohan ◽  
Jacob Wulff ◽  
Melissa Maisenbacher ◽  
J. Dianne Keen-Kim ◽  
...  

2021 ◽  
Vol 20 (7) ◽  
pp. 698-702
Author(s):  
E. I. Ado

Recognition of congenital heart defects, in particular the determination of the exact localization of the lesion in them, is often associated with rather significant difficulties, and sometimes it is completely impossible.


Author(s):  
A Schure

Since the introduction of cardiac catheterisation for Paediatric Cardiology in 1947, the subspecialty has seen dramatic changes. The advancement of non-invasive imaging techniques such as echocardiography, CT and cardiac MRI has shifted the focus for paediatric cardiac catheterisations from a primarily diagnostic tool (to define anatomy, assess haemodynamics and calculate shunts) to an important treatment option for various congenital heart defects.


2019 ◽  
Vol 29 (4) ◽  
pp. 499-504
Author(s):  
Münevver T. Temel ◽  
Seniz Demiryürek ◽  
Ahmet Saracaloglu ◽  
Celal H. Ozer ◽  
Hale N. Kahraman ◽  
...  

AbstractOxidative stress may contribute to the pathogenesis of congenital heart defects, but the role of dynamic thiol/disulphide homeostasis has not been evaluated. The objective of this study was to assess whether there are changes in thiol/disulphide homeostasis and nitric oxide levels in children with tetralogy of Fallot (TOF) and ventricular septal defect (VSD). A total of 47 children with congenital heart defects (24 TOF and 23 VSD) and 47 healthy age- and sex-matched controls were included in this study. Serum total thiol and native thiol levels were measured using a novel automatic spectrophotometric method. The amount of dynamic disulphide bonds and related ratios were calculated from these values. Serum nitric oxide levels were detected using a chemiluminescence assay. We found that the average native thiol, total thiol, and disulphide levels were decreased in patients with VSD when compared with healthy individuals (p < 0.001, p < 0.001, and p < 0.01, respectively). While native thiol levels were decreased (p < 0.01), disulphide levels were elevated in the TOF group (p < 0.05). We observed marked augmentation of disulphide/native thiol (p < 0.001) and disulphide/total thiol ratios (p < 0.01) in the TOF group. However, there was a significant decrease in native thiol/total thiol ratio in patients with TOF. No significant changes in these ratios were noted in the VSD group. We detected significant elevations in serum nitric oxide levels in children with TOF and VSD (p < 0.001 for all). These results are the first to demonstrate that thiol/disulphide homeostasis and nitric oxide are associated with TOF and VSD in children.


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