Mejores posters del XXI Congreso Internacional de Pediatría de la Sociedad Ecuatoriana de Pediatría. Quito, 12-14 Agosto 2021

Introducción: El XXI Congreso Internacional de pediatría de la Sociedad Ecuatoriana de Pediatría fue llevado del 12 al 14 de agosto del 2021 en la ciudad de Quito-Ecuador. El objetivo del congreso fue mantener la actividad académica de la sociedad núcleo de Quito durante la pandemia de COVID-19 con el lema “Por una Atención Pediátrica Integral durante la pandemia de COvid-19”. Métodos: En modalidad virtual se realizaron videoconferencias en los temas de cardiología, gastroenterología, infectología, inmunizaciones, neonatología, neurología, nefrología, nutrición, traumatología, terapia intensiva, oncología y psicología. Se presentan los mejores posters del congreso. Resultados: Un comité de expertos seleccionó los mejores casos clínicos. Se seleccionaron los mejores posters de casos clínicos: Stent ductal bilateral en neonato con ramas arteriales pulmonares discontinuas: reporte de caso. Caso clínico: De la Acidosis tubular a la alcalosis metabólica. Síndrome de Miller Fisher, variante de guillain barré: reporte de caso. Los mejores estudios: Proyecto “mi familia como parte de mi cuidado¨ en la unidad de neonatología del Hospital Metropolitano basados en la filosofía” Family Center Care”, Factores asociados a obesidad en niños entre 5-12 años de edad, Hospital Carlos Andrade Marín, 2018. Estudio Retrospectivo Longitudinal sobre la Relación entre Trastorno del Espectro Autista (TEA) y Epilepsia en una Población Pediátrica en Quito-Ecuador. Lactancia materna en recién nacidos y lactantes con alergia a las proteínas de la leche de vaca: un estudio retrospectivo.

Is higher-level trauma center care associated with better outcomes in patients injured by low-energy trauma?

Background In high-income countries trauma patients are becoming older, more likely to have comorbidities, and are being injured by low-energy mechanisms, chiefly ground-level falls. It is currently unknown whether existing trauma systems improve the outcomes of these patients. This systematic review investigates the association between higher-level trauma center care and outcomes of adult patients who were admitted to hospital due to injuries sustained following low-energy trauma. Methods A pre-registered systematic review (CRD42020211652) of subject databases and grey literature, supplemented by targeted manual searching, was conducted in January 2021. Studies were eligible if they reported outcomes in adults admitted to hospital due to low-energy trauma. Studies were excluded if participants were not adults or were not admitted to hospital. Studies in lower- and middle-income settings were excluded due to differences in demographics and healthcare systems. Risk of bias was assessed by independent reviewers using the Robins-I tool. In the presence of study heterogeneity a narrative synthesis was pre-specified. Results Three observational studies were included from 2,898 unique records. The studies' risk of bias was moderate-to-serious due to potential residual confounding and selection bias. All studies compared outcomes among adults injured by ground-level falls treated in trauma centers verified by the American College of Surgeons in the USA. The studies reported divergent results. One demonstrated improved outcomes in level 3 or 4 trauma centers (Observed: Expected Mortality 0.973, 95%CI 0.971-0.975), one demonstrated improved outcomes in level 1 trauma centers (Adjusted Odds Ratio 0.71, 95%CI 0.56-0.91), and one demonstrated no difference between level 1 or 2 and level 3 or 4 trauma center care (Adjusted Odds Ratio 0.91 (0.80-1.04). Conclusions There is currently no strong evidence for the efficacy of major trauma centers in caring for adult patients injured by a ground-level fall. Further studies at lower risk of bias and studies conducted outwith the USA are required.

Augmented Reality for Health Education's Model to Children with ARI (Acute Respiratory Infection) Culture Based Through Family Center Care Approach

Acute Respiratory Infection is the main problem that always consulted or hospitalization in health care facilities, especially in the child care room. This study aims to identified health education's model to children with ARI (Acute Respiratory Infection) culture based through Family Center Care approach. This method is choosen to indeep interview out at child room in Jember Balung Hospital on may - september 2020. The subjects of the study are amount of eight person involving six nurses and two person from the families of children with ARI. The instruments used by TANNAHILS MODEL. The researcher identified 4 themes as a result of the study then all the themes are explained based on the specific objectives of the study. All the themes have sub-themes with specific categories of meaning. The results from themes that is identified in the study of interviews with preventive health protection are that each parent is different. One of the results of interviews about educational media that are suitable for the prevention of ARI in children are more often done using without media or “lesan” only when certain conditions use leaflets if needed. However, along with current technological developments, educational media are modified as attractive as possible to increase children's interest, one of which is educational media in the form of Augmented Reality (AR).

MODIFIKASI MAKANAN UNTUK MENINGKATKAN GIZI BALITA DI KABUPATEN POLEWALI MANDAR

Penanggulangan balita gizi kurang dilakukan dengan cara modifikasi makanan atau berubah bentuk dan rasa makanan dari yang kurang menarik menjadi lebih menarik dan menampilkan bentuk yang lebih bagus dari aslinya.pemenuhan gizi pada balita berkaitan erat pada fungsi keluarga,dengan demikian keluarga mempunyai peran penting dalam praktik pemenuhan gizi balita. Adapun upaya atau strategi yang akan dilakukan penulis yaitu melakukan intervensi pendekatan dengan menggunakan system family Center Care kepada keluarga dalam melakukan kalaborasi guna memenuhi gizi pada balita secara mandiri yaitu melakukan modifikasi makanan balita. Berdasarkan hasil pemantauan Gizi tahun 2017 presentase gizi kurang Provinsi Sulawesi Barat balita sebesar 19,9% Dari 6 kabupaten di Sulawesi Barat Kabupaten Polewali Mandar berada pada posisi 4. Tujuan dilakukannya penelitian ini untuk melakukan modifikasi makanan pada balita untuk mengurangi prevalensi gizi kurang pada balita, dengan menggunakan jenis penelitian kuantitatif menggunakan design quasi eksperimental dan menggunakan lembar observasi guna mengetahui faktor yang menjadi masalah gizi pada balita penelitian ini digunakan karena peneliti mengelompokkan anggota sampel dan dibagi kedalam dua kelompok dengan perlakuan yang berbeda yaitu kelompok perlakuan dan kelompok control. Penelitian dilakukan di Desa Rumpa dan Buku, Kecamatan Mapilli, Kabupaten Polewali Mandar, Provinsi Sulawesi Barat. Waktu penelitian dimulai pada tanggal 27 Juli dan 05 September 2020. Data diolah dengan menggunakan analisis data uji statistic Chi Squart dengan tingkat signifikan p<0,05 dan jumlah responden sebanyak 70 orang dengan masing-masing kelompok berjumlah 35 orang. Hasil penelitian pada kelompok perlakuan mengalami perubahan yang signifikan sedangkan pada kelompok control tidak menunjukkan adanya perubahan yang signifikan. Malnutrition is still one of the main public health problems in Indonesia,The prevalence of malnutrition in Indonesia is still quite high. Based on the results of nutrition monitoring in 2017 the percentage of undernutrition in West Sulawesi Province under five was 19.9% ??of 6 district in West Sulawesi Polewali Mandar district is in position 4. Objectives This research was conducted to modify food in toddlers forreduce the prevalence of malnutrition in children under five and to practice manufacturing methods PMT in malnourished mothers of children under five. This type of research is quantitative and research design isquasi experimental and use the observation sheet to determine which factors become a nutritional problem in toddlers. The study population was all children under five with nutritional status less in two villages namely Rumpa Village and Buku Village, Mapilli District, Polewali Regency Mandar West Sulawesi. The number of samples is 70 respondents divided into 2 groups (treatment group and control group) each research group there are 35 respondents according to the research inclusion criteria. Sampling technique using the observation sheet and processing the data using Paired test data analysis sample t test, with a significant level of p <0.05. The timing of the study began on the 27 July and September 05 2020. Research results There is a significant relationship between food modification (menu preparation, food processing, food presentation and methods feeding) and the practice of how to make PMT Toddler results obtained a significant level p value (p = 0.00) and there is an effect of food modification and practice of making PMT to changes in body weight under five. Obtained well-nourished toddlers as much as 18 (52.4) 17 (47.6) people and children under five who were still malnourished.

The value of a novel model of remote monitoring alert classification of cardiac implantable devices

Introduction Remote monitoring (RM) is commonly used in the follow-up of patients with cardiac implantable devices (CID). However, there are a significant amount of automatic alerts of low clinical relevance. An alert classification model designed to optimize the management of RM alert in CID receivers can improve the analysis. Purpose Assess the effectiveness of a local protocol for review and classification of MR alerts. Methods Retrospective study, single center. We included all patients with ICD +/− CRT in the RM program between september 2016 and december 2019. All transmission received were analyzed. The priority of the transmissions was established based on clinical criteria and device parameters, classified into 3 categories from lowest to highest priority: green, yellow and red. Each category involved a specific action protocol (Figure 1). The categorization by colors was initially carried out by a remote support center, based on data from the devices; and later, reviewed by arrhythmia nurse team who incorporated clinical information data. In case of discrepancy, the alert was again evaluated together with the cardiologist. The degree of concordance in the categorization of alerts was analyzed, as well as the transmission response time (TRT): support center- care team. Results In our center a total of 1013 patients were included (68±14 years old, 76% male), who completed 8755 remote transmissions. The initial classification of transmissions by the support center was: 6890 (78.7%) green, 1497 (17.1%) yellow and 368 (4.2%) red. Only 0.62% of transmissions required reclassification by the healthcare team. No alert initially classified as yellow or green should be reclassified to red. The TRT was 3.35 hours for the red transmissions and 5.6 hours for the yellow ones. Conclusion The categorization of alerts in our RM system allows an efficient and safe organization of assitance to patients with CID. Funding Acknowledgement Type of funding source: None

Mobile-Health (mHealth) Intervention on Chronic Kidney Diseases: A Critical Review and Its Implications (Preprint)

BACKGROUND eElectronic health (eHealth) chronic kidney disease (CKD) information is readily available over the mobile devices and placed as mobile-health (mHealth) information resources. The field of mHealth on CKD is promising in that it can empower individuals and delay the progress of the disease. OBJECTIVE This study aims to critically review published papers on the eHealth and its implication on mHealth of CKD. METHODS The academic databases EBSCO (CINAHL and PROQUEST), MEDLINE, PubMed, and Cochrane were systematically searched. Eight studies investigated the specific role of mHealth on CKD, including the detailed contents related to the conceptual acceptance and usage of technology in daily life, user, health care professionals, and the system’s bonding, mobile eHealth, content and evaluation of mHealth on CKD. RESULTS The available evidence on mHealth of CKD is limited and the findings indicate a discrepancy of the wording concept of mHealth. Those evidences might be caused by the scarce evidence on the effectiveness of using mHealth on CKD. CONCLUSIONS The limitation on the availability of CKD’s mobile health interventions that focus on patient education, behavior change and prevention contributes to inconsistent usage. Inadequate evidence might interrupt the development of mHealth intervention for individuals with CKD. Our findings illustrate the need on the conceptualizing of mHealth on CKD, acceptance and accessed, content, and evaluation focused on evidence-based will advance the quality of mHealth services, facilitate the continuity of mHealth application, and proposed patient-center-care.