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1.
Cureus ; 14(11): e31643, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36540482

RESUMO

BACKGROUND:  Myocarditis is a leading cause of morbidity and mortality in the pediatric age group and contributes to a wide range of complications, including dilated cardiomyopathy, congestive heart failure, and even death, so early identification and comprehensive management are essential for a favorable outcome. OBJECTIVES:  Summarize the presenting clinical signs and symptoms of pediatric patients with a diagnosis of myocarditis and a poor outcome and correlate the clinical presentation and laboratory and radiographic findings to identify possible predictors of a poor outcome. METHODS:  This retrospective cohort study included all patients who were diagnosed with myocarditis and followed up at King Abdulaziz University Hospital, Jeddah, Saudi Arabia over the 13 years between January 01, 2007, and December 31, 2019. Information on patient demographics, clinical presentation, and non-invasive investigations was obtained. Poor outcomes were defined as death or evidence of left ventricular dysfunction on echocardiography which was evaluated at two points in time as an early outcome and a late outcome. RESULTS:  Seventeen patients (male 52.9%, female 47.1%) with a median age of 4 ± 4.31 years are included. The most frequent initial complaints were exercise or feeding intolerance, respiratory symptoms, and shortness of breath. On the other hand, hepatomegaly and respiratory distress were the most common clinical signs. All the patients were admitted to the pediatric intensive care unit but only 41% required mechanical ventilation. The presence of a murmur at presentation was significantly correlated with a poor early outcome. Ischemic changes on the electrocardiogram and moderate left ventricular dysfunction on the echocardiogram were significantly correlated with a poor late outcome. CONCLUSION:  Diagnosis of myocarditis can be established by a combination of clinical presentation and investigative tools. A murmur, ischemic changes on the electrocardiogram, and left ventricular dysfunction are important predictors of myocarditis in children.

2.
Saudi Med J ; 41(6): 622-627, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32518929

RESUMO

OBJECTIVES: To validate the web weight gain-based WINROP (weight, insulin-like growth factor I, neonatal, retinopathy of prematurity [ROP]) algorithm retrospectively to identify type 1 ROP in a Saudi cohort of premature infants.  Methods: The records of preterm infants (greater than 23 and less than 32 weeks gestation) born between August 2013 and October 2018, were reviewed. Birth weight, gestational age, and weekly weight measurements of the premature infants were entered online. Based on weekly weight gain, the WINROP algorithm alerted clinicians whether infants were at high-risk for vision­threatening type 1 ROP. Sensitivity, specificity, positive and negative predictive values were calculated. Results: The median gestational age of the infants at birth was 28 weeks, with median birth weight at 1085 g. Of the 175 infants included in the study, 13 (7.4%) developed type 1 ROP. WINROP positive alarm was triggered in 70.9% (124/175) of all infants and 100% (13/13) of those treated for type 1 ROP. The specificity of the algorithm was 31.5%. Positive predictive values was 10.5% and negative was 100%. Conclusion: The general WINROP sensitivity in identifying type 1 ROP was 100% similar to that reported in developed countries; however, its specificity was low at 31.5%. Tweaking of the algorithm based on the population may increase the specificity and promote the practical utility of this non-invasive screening tool for ophthalmologists and neonatologists in this population.


Assuntos
Técnicas de Diagnóstico Oftalmológico , Recém-Nascido Prematuro , Programas de Rastreamento/métodos , Retinopatia da Prematuridade/diagnóstico , Algoritmos , Peso ao Nascer , Estudos de Coortes , Humanos , Lactente , Recém-Nascido , Fator de Crescimento Insulin-Like I , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Aumento de Peso
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