Faktor-faktor yang Mempengaruhi Psikososial Pesakit Kanakkanak Talasemia

@#Introduction Thalassemia disease is a serious health problem as it gives psychosocial burden not only to the patients but also to the patients’ ecosystem. Among the difficulties faced by patients are psychosocial problems, especially in the process patients’ growth and development. Therefore, this study examines what factors can influenced the psychosocial of Thalassemic patients.. Methods A cross-sectional study was carried out among 161 of Thalasemia Major children at Women and Children Hospital, Likas and Keningau District Hospital, Sabah from February to April 2013. The validated PedsQL 4.0 Generic Core Scale and Social Support questionnaire has been used. Results The results showed that the overall psychosocial score was 68.50 (SP 15.18) with the lowest average school psychosocial score of 58.38 (SP 17.82). Only gender factor showed a significant relationship with psychosocial score of emotional function. There is no significant relationship noted between other sociodemographic factors with overall psychosocial scores or with the psychosocial scores of each function. In relation to subscale social support factors, there was a significant relationship between the psychosocial scores of each function and overall with social support factors of parents, close friends, classmates and teachers. The results of linear regression multivariate analysis suggest that social support factors from classmates is a significant factor in the psychosocial impact of Thalassemia Major pediatric patients. Conclusions In conclusion, social support factors primarily from peers are very important in influencing the psychosocial of Thalassemia Major children in overcoming their life's functionality like other normal children

Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs): an intriguing EEG phenomenon / Descargas ictais, periodicas ou ritmicas induzidas por estimulos (SIRPIDs): um fenomeno EEG intrigante

SIRPIDs, an acronym for stimulus-induced rhythmic, periodic, or ictal discharges, were first named in 2004. This is a pattern observed in continuous electroencephalogram (CEEG) consistently elicited by stimulation in comatose patients. The pathophysiology of SIRPIDs probably involves dysregulation of subcortico–cortical projections, particularly thalamocortical circuit, in a markedly abnormal brain with hyperexci­table cortex. This may explain some studies found an association of prolonged periodic epileptiform discharges (PEDs) activity and a higher incidence of concurrent electrographic seizures and SIRPIDs. An association of SIRPIDs and poor prognosis has already been described. However, it is not yet possible to assert whether these discharges can cause neuronal injury or if they are simply a marker of severe brain injury. Objective of this paper is to review clinical relevance and pathophysiology of SIRPIDs, as well as its role as a brain response in the critically ill patient.

O termo SIRPIDs é um acrônimo do inglês que pode ser traduzido como: descargas ictais, periódicas ou rítmicas induzidas por estímulos e foi utilizado pela primeira vez em 2004. Este padrão é observado no eletroencefalograma contínuo (CEEG) obtido pela estimulação de pacientes comatosos. A fisiopatologia dos SIRPIDs provavelmente envolve uma falha na regulação das projeções corticais e subcorticais, particularmente nos circuitos talamocorticais, num cérebro anormal com o córtex hiperexcitável. Isso pode explicar a associação encontrada por alguns estudos entre as descargas epileptiformes periódicas (PEDs) prolongadas e uma maior incidência de crises eletrográficas, bem como de SIRPIDs. É descrita associação entre os SIRPIDs e pior prognóstico. Ainda não é possível determinar se estas descargas podem causar dano neuronal ou se elas são simplesmente marcadoras de lesão cerebral grave. O objetivo deste artigo é revisar a relevância clínica, a fisiopatologia dos SIRPIDs e seu papel como resposta cerebral no paciente crítico.

Osteogénesis imperfecta: estudio de la calidad de vida en los niños / Osteogenesis imperfecta: quality of life in children

La calidad de vida relacionada con la salud (CVRS) en los niños con osteogénesis imperfecta (OI) ha sido poco comunicada. Se la evaluó con el cuestionario Peds QL versión 4.0, en 65 familias y 42 niños, con una media de edad de 7,76 años (35 con OI de tipo I y 30 con OI de tipo III-IV). Hubo diferencias signifcativas en el dominio físico según los niños y los padres, entre los niños con OI de tipo I y aquellos con OI de tipo III-IV. En el dominio social solo los padres consideraron menor CVRS en las formas III-IV. En el análisis multivariado de las formas graves, para los padres la mejor CVRS se asoció con menor défcit de estatura (coef. β = 3,8; p= 0,039), menor número de fracturas (coef. β= 0,69; p= 0,003) y mayor dosis de pamidronato (coef. β= 1,44; p= 0,037). Para los niños, la CVRS fue mejor cuando hubo adherencia al tratamiento (coef. β= 19,41; p= 0,03).

The impact produced by osteogenesis imperfecta in childrens' quality of life almost has not been reported; 65 children, 38 males, were evaluated according to the questionnaire PedsQL 4.0 Argentinean Spanish version. Median age was 7.76 years; 35 children with OI type I were compared with 30 type III-IV (according to Sillence Classifcation) fnding signifcant difference in the physical domain in both visions, children and parents, and only in parents' vision in the social area. Multivariate analysis showed an association between better PedQL scores and treatment compliance (coef. β= 19.41 p= 0.03) in children's vision. In parental report on the other hand, the association was found with greater pamidronate doses (coef. β 1.44 p=0.037), lower height compromise (coef. β= 3.8; p= 0.039) and less number of fractures (coef. β= 0.69; p= 0.003).

Comparison of the BACTEC Peds Plus Pediatric Blood Culture Bottle to the BacT/Alert PF Pediatric Blood Culture Bottle for Culturing Blood from Pediatric Patients / 대한임상미생물학회지

BACKGROUND: We compared the BACTEC Peds Plus (Becton Dickinson, USA) and BacT/Alert PF (bioMerieux, France) pediatric blood culture bottles in the context of recovery and time to detection (TTD) of bacteria and fungi from pediatric patients. METHODS: Blood samples were collected for culture from pediatric patients who were hospitalized during 2010 at a university hospital. BACTEC Peds Plus and BacT/Alert PF bottles were placed in the BACTEC FX and BacT/Alert 3D blood culture system, respectively, and tested for 5 days. Bottles flagged by instruments as positive were removed from the instruments and the TTDs were recorded. RESULTS: A total of 5,018 sets (1 set, 1 BACTEC Peds Plus and 1 BacT/Alert PF) were evaluated. Overall, the recovery proportions for BACTEC Peds Plus and BacT/Alert PF bottles were 57% (134/195) and 69% (112/195), respectively. There was a significant difference between the 0.38% contamination rate in BacT/Alert PF bottles and the 0.16% contamination rate in BACTEC Peds Plus bottles (P=0.035). The average TTD for all microorganisms was significantly decreased for the BACTEC Peds Plus bottles (P=0.021), but was increased for Candida parapsilosis compared to the results for the BacT/Alert PF bottles (P=0.028). CONCLUSION: We conclude that the rate of detection and contamination is higher when BacT/Alert PF bottles are used than when BACTEC Peds Plus bottles are used for pediatric blood culture. The BACTEC Peds Plus bottles detect nearly all enrolled microorganisms significantly faster than do the BacT/Alert PF bottles.