scholarly journals Factors Associated with Severe Lower Respiratory Tract Infection from Respiratory Syncytial Virus (RSV) in Thai Children

2021 ◽  
Vol 73 (12) ◽  
pp. 808-814
Author(s):  
Atipotsawee Tungsupreechameth ◽  
Klaita Srisingh
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Stay ◽  
Logistic Model ◽  
Congenital Heart ◽  
Clinical Manifestations ◽  
Factors Associated ◽  
Duration Of Hospital Stay ◽  
Significant Difference ◽  
Syncytial Virus

Objective: To determine the factors associated with severe ALRTI from RSV in children.Materials and Methods: A retrospective study of children aged 1-60 months were conducted from 2014 to 2018. Out of 269 patients diagnosed with RSV ALRTI, 100 children were enrolled in the study, 20 had severe RSV ALRTI, while 80 had non-severe RSV ALRTI as identified by the ReSVinet scale. A multivariable logistic model was conducted to select significant variables.Results: During the study period, 269 patients were diagnosed with RSV ALRTI. Mean age was 10.45 ± 3.53 months. Clinical manifestations of severe RSV ALRTI group had significant difference in abnormal general condition (P < 0.001), tachypnea (P < 0.001), SpO2 < 85% (P < 0.001), poor air entry in lungs (P < 0.001), and retraction (P < 0.001). The factors associated with severe RSV ALRTI group, were underlying congenital heart disease [aOR32.45; 95% CI 3.38-311.87, P = 0.003] and duration of hospital stay >5 days [aOR 19.56; 95% CI 1.81-212.05, P = 0.014].Conclusion: Factors associated with severe RSV ALRTI in children were underlying congenital heart disease andduration of hospital stay >5 days.

Abstract 13794: Serial Brain Metabolism in Term Neonates With Congenital Heart Disease: Association With Clinical Factors and Neurodevelopmental Outcomes

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Anna L Harbison ◽  
Jodie K Votava-Smith ◽  
Sylvia Del Castillo ◽  
S Ram Kumar ◽  
Vincent K Lee ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Stay ◽  
Congenital Heart ◽  
Brain Metabolism ◽  
Clinical Factors ◽  
Neurodevelopmental Outcomes ◽  
Term Neonates ◽  
Significant Difference ◽  
Serial Brain

Objectives: Term congenital heart disease (CHD) neonates demonstrate pre-operative (op) abnormal brain metabolism (reduced N-acetylaspartate (NAA), elevated lactate) on long echo MR spectroscopy (MRS). We sought to delineate associations between serial brain metabolism and patient and perioperative clinical factors in term neonates with CHD using short echo MRS. We measured NAA and lactate as well as other metabolites important for brain connectivity such as neurotransmitters glutamate/glutamine and GABA. Methods: Subjects were prospectively enrolled to undergo pre and post-op 3T short echo single voxel MRS of parietal white matter with absolute quantitation of 15 metabolites using LCModel. Neurodevelopment (ND) was assessed via 18 month Battelle Developmental Inventory. Linear and logistic regression with false discovery rate correction was used for statistical analysis. Results: Eighty subjects were enrolled 2009-2015 and 21 term CHD infants underwent both pre and post-op MRS. Eight infants had at least one MRS and ND. NAA and glutamate were significantly decreased post-op compared to pre-op (p<0.0001), with no significant difference in other metabolites. Pre-op factors including lower Apgar score, birth weight, head circumference and PaO2 and higher arterial pH and serum lactate were associated with lower NAA (p<0.002). Single ventricle anatomy was associated with low NAA, high myo-inositol and low glutamine/glutamate compared to two ventricles (p<0.01). Longer cardipulmonary bypass time, but not deep hypothermic circulatory arrest, was associated with reduced NAA (p<0.001). Post-op, global alteration in multiple serial brain metabolites (NAA, lactate, glutamate/glutamine, GABA, myo-inostol) were associated with longer ICU and hospital stay (p<0.03). In those with ND testing, high GABA correlated with low cognitive domain score, while high glutamine correlated with low motor score (p<0.03). Conclusion: In term CHD neonates, serial brain metabolism by MRS demonstrates alterations beyond NAA, including neurotransmitters GABA and glutamate/glutamine. These abnormalities are associated with multiple clinical pre and post-op factors and also predict prolonged hospital stay and 18 month ND.

scholarly journals Factors associated with a lower chance of having gaps in care in adult congenital heart disease

2021 ◽  
pp. 1-6
Author(s):  
Jong Mi Ko ◽  
Lisa R. Yanek ◽  
Ari M. Cedars
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Adult Congenital Heart Disease ◽  
Multivariable Logistic Regression Analysis ◽  
Study Cohort ◽  
Factors Associated ◽  
Paediatric Care ◽  
Significant Difference ◽  
Care Gaps

Abstract Background: To promote good health in patients with congenital heart disease (CHD), prevention of gaps in care is essential, as adverse prognosis is associated with care gaps. A well-organised, formal transition programme may help prevent loss to follow up after leaving paediatric care. To inform the development of a transition programme, we investigated factors associated with care gaps in adults with CHD. Methods: Between 15 October 2018 and 15 November 2019 data on patient characteristics and patient experiences with transition-related education, difficulties, and gaps in care were collected and assessed in 87 adults with CHD. Two groups (with gaps in care versus without gaps) were compared to identify informative differences using chi-squared, Fisher’s exact tests, or Wilcoxon rank-sum tests. To assess the relationship between care gaps and identified variables, factors with significant difference (p < 0.05) in bivariate analyses were employed as covariates in multivariable logistic regression analysis. Results: About half of the study cohort reported having gaps in care. In a multivariate model, patients having thorough discussion about the importance of receiving adult care in paediatric care were 70% less likely to experience gaps (odds ratio 0.303, 95% CI 0.14, 0.66). Forty-seven percent of patient-perceived barriers to transitioning originated from negative feelings associated with transfer. Conclusion: Gaps in care are highly prevalent in adults with CHD. For a transition programme to be most effective, curriculum development may need to consider the differential impact of various factors and target areas to mitigate the psychological stress associated with transfer.

scholarly journals Behcet Uz Cocuk Hast Derg. 2021; 11(2): 174-180 | DOI: 10.5222/buchd.2021.60320 Does Prophylaxis Against Respiratory Syncytial Virus Infection Affect the Weight Percentiles of Infants with Hemodynamically Significant Congenital Heart Disease?

2021 ◽  
Author(s):  
Ali Orgun ◽  
İbrahim İlker Çetin ◽  
Hazım Alper Gürsu
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Respiratory Syncytial Virus ◽  
Congenital Heart ◽  
Humanized Monoclonal Antibody ◽  
Number Of Patients ◽  
Significant Difference ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
Weight Percentile

Objective: The risk of severe respiratory syncytial virus (RSV) infection with significant morbidity and mortality is greatest in patients with hemodynamically significant congenital heart disease (hs-CHD). The humanized monoclonal antibody, palivizumab, was used as prophylaxis for RSV infection in children <24 months of age suffering from hs-CHD. We performed this study to evaluate the effects of RSV prophylaxis with palivizumab on the weight percentiles of infants with hs-CHD. Methods: During the RSV seasons between 2013 and 2017, children <24 months of age with hs-CHD who received ≥3 doses of palivizumab prophylaxis were included in this study. All patients were evaluated according to their weight percentiles examined at birth, at the first, and the last dose of palivizumab prophylaxis. The third percentile was accepted as the cut-off value of the lower weight percentile, and values below the 25th percentile were accepted as poorly controlled hs-CHD. Results: Sixty-one infants aged between 10 days and 15 months were included in the study. The infants received the first dose of palivizumab at the age of 5 months, and all infants received 4.56±0.78 injections on an average. The number of patients weighing lower than the 25th percentile at the first, and the last dose of palivizumab were 36 (59 %) and 29 (47.5 %), respectively. A statistically significant difference was found between weight percentiles of infants at the first and the last dose of palivizumab (p<0.05). Discussion and conclusion: RSV prophylaxis with palivizumab affects weight percentiles positively, and it may help to reduce the hospitalization rate due to RSV infections in infants with hs-CHD.

scholarly journals Clinical Factors Associated with Cerebral Metabolism in Term Neonates with Congenital Heart Disease

2017 ◽  
Vol 183 ◽  
pp. 67-73.e1 ◽  
Author(s):  
Anna Lonyai Harbison ◽  
Jodie K. Votava-Smith ◽  
Sylvia del Castillo ◽  
S. Ram Kumar ◽  
Vince Lee ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Cerebral Metabolism ◽  
Clinical Factors ◽  
Term Neonates ◽  
Factors Associated

scholarly journals Pattern and Clinical Profile of Congenital Heart Disease in A Teaching Hospital

1970 ◽  
Vol 21 (1) ◽  
pp. 58-62 ◽  
Author(s):  
L Shamima Sharmin ◽  
M Azizul Haque ◽  
M Iqbal Bari ◽  
M Ayub Ali
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Stay ◽  
Congenital Heart ◽  
Growth Failure ◽  
Female Child ◽  
Feeding Problems ◽  
Medical College ◽  
One Year ◽  
A Prospective Study

Objectives: To see the (a) type of congenital heart disease, (b) Clinical presentation of the cases, (c) association with extra-cardiac anomalies and disease, (d) complications of different CHD, (e) outcome of patients during hospital stay. Methodology: it was a prospective study conducted in the department of pediatrics of Rajshahi Medical College & Hospital over a period of one year.115 children from birth to 12 years of age who had congenital heart disease confirmed by echocardiography were included. All patients were treated conservatively and observed for immediate out come during the hospital stay. Result: major types of CHD were VSD (42.6%), TOF (18.3%), ASD (14.8%), PDA (7.8%). Male outnumbers female child. Common symptoms were breathlessness (60%), fatigue (54.8%), cough (43.5%), poor weight gain (41.7%), recurrent chest infection (34.8%), fever (28.7%), feeding problems (26.1%), palpitation (21.7%) and bluish discoloration of lips and fingertips (20%). Murmur with or without thrill and cardiomegaly was the most important cardiac finding. Frequently observed complications were heart failure, pulmonary hypertension and growth failure.   doi: 10.3329/taj.v21i1.3221 TAJ 2008; 21(1): 58-62

scholarly journals Cyanotic congenital heart disease: Impact on growth and endocrine functions.

2021 ◽  
Vol 28 (10) ◽  
pp. 1477-1483
Author(s):  
Muhammad Sohail Arshad ◽  
Waqas Imran Khan ◽  
Arif Zulqarnain ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Mudasser Adnan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pulmonary Stenosis ◽  
Tertiary Care ◽  
Cyanotic Congenital Heart Disease ◽  
P Value ◽  
Common Diagnosis ◽  
Significant Difference ◽  
The Impact

Objective: To find out the impact of Cyanotic Congenital Heart Disease (CCHD) on growth and endocrine functions at a tertiary care child healthcare facility of South Punjab. Study Design: Case Control study. Setting: Department of Pediatric Cardiology and Department of Pediatric Endocrinology, Institute of Child’s Health (ICH), Multan, Pakistan. Period: December 2018 to March 2020. Material & Methods: During the study period, a total of 53 cases of Echocardiography confirmed CCHD were registered. Along with 53 cases, 50 controls during the study period were also enrolled. Height, weight, body mass index (BMI) along with hormonal and biochemical laboratory investigations were done. Results: There was no significant difference between gender and age among cases and controls (p value>0.05). Most common diagnosis of CCHD among cases, 24 (45.3%) were Tetralogy of Fallot (TOF) followed by 9 (17.0%) transposition of the great arteries (TGA) with Ventricular Septal Defect (VSD) with Pulmonary Stenosis (PS). Mean weight of CCHD cases was significantly lower in comparison to controls (21.19+6.24 kg vs. 26.48+8.1 kg, p value=0.0003). Blood glucose was significantly lower among cases in comparison to controls (77.58+14.58 mg/dl vs. 87.25+11.82 mg/dl, p value=0.0004). No significant difference was found in between cases and controls in terms of various hormone levels studied (p value>0.05) except Insulin-like Growth Factor-1 (IGF-1) levels (p value<0.0001). Conclusion: Children with cyanotic congenital heart disease seem to have negative effects on nutrition and growth. Change in pituitary-adrenal axis is suspected while pituitary-thyroid axis seemed to be working fine among CCHD cases. Serum glucose and IGF-1 levels were significantly decreased among CCHD cases.

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