Marija Meštrović

Desfecho funcional de crianças tratadas em unidade de terapia intensiva

OBJETIVO: O desfecho de pacientes nao e somente determinado pelo indice de gravidade de doenca, mas tambem pelo impacto do estado pre-admissao de comorbidade dos pacientes. Portanto, este artigo buscou avaliar o desfecho de pacientes tratados em uma unidade de terapia intensiva pediatrica, com foco especial no grupo de criancas com doencas cronicas. METODOS: Os dados foram obtidos prospectivamente, e o desfecho foi avaliado segundo a escala Pediatric Overall Performance Category para 449 pacientes de uma unidade de terapia intensiva pediatrica do Split University Hospital. O desempenho funcional foi avaliado como o escore pre-admissao e o escore na alta hospitalar em pacientes com alteracoes neurodesenvolvimentais, com outras doencas cronicas e sem doenca cronica. RESULTADOS: O estado funcional a alta hospitalar foi significativamente dependente do estado funcional pre-admissao e da mortalidade prevista. Criancas com alteracoes neurodesenvolvimentais apresentaram escore basal significativamente pior e deterioracao de morbidade funcional na alta hospitalar significativamente menor, comparadas com criancas sem doenca cronica e com criancas com outras doencas cronicas. CONCLUSOES: A escala Pediatric Overall Performance Category demonstrou sua aplicabilidade em uma pequena unidade de terapia intensiva com uma populacao heterogenea de pacientes. Deve, portanto, ser considerada para avaliacao regular de qualidade de cuidados a saude como uma ferramenta simples e precisa. Ao contrario do que acontece com outros pacientes, o estado funcional de criancas com alteracoes neurodesenvolvimentais foi marcadamente influenciado por sua comorbidade. Seu estado pre-admissao foi pior do que o de outras criancas e, por isso, nao poderia estar significativamente deteriorado na alta hospitalar.

Prevalence of G-6-PD Deficiency in the Croatian Adriatic Coast Population

BACKGROUND The objective of this study was to determine the prevalence of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency among the population of the Croatian Adriatic Coast, part of the Mediterranean basin. METHODS The fluorescent spot test was used to screen 2,726 randomly selected high school students in the Croatian Adriatic coastal area. Fluorescence readings were performed at the beginning and at 3, 6, 10, and 25 min of incubation. Results were classified into the following three groups: bright fluorescence (BF), weak fluorescence (WF), and no fluorescence (NF). All NF and WF samples at 3 min were quantitatively measured using the spectrophotometric method. RESULTS Twelve persons, 10 boys and 2 girls, were found to be deficient in G-6-PD, rendering a 0.44% prevalence of G-6-PD deficiency. All NF samples at fluorescent spot test were G-6-PD-deficient. WF at 3 min of the incubation period was present in 33 (1.2%) subjects, and only 2 (6%) were true positive. Fluorescence reading at 10 min of incubation omits five (41%) of the G-6-PD deficient samples. CONCLUSIONS Prevalence of G-6-PD deficiency in the Croatian Adriatic coastal population is 0.44%. Fluorescent spot test for moderate enzyme deficiency is reliable in early fluorescence reading.

Neurodevelopmental disabilities and quality of life after intensive care treatment

Aim:  To analyze the quality of life after Pediatric Intensive Care Unit (PICU) treatment and compare the differences between quality of life in children who suffer chronic health conditions, and those who do not, post discharge from PICU.

Congenital Syphilis Associated with Hyperlipoproteinemia

Abstract: An infant with congenital syphilis associated with transient disturbances of lipoprotein metabolism is reported. The dominant clinical sign was hepatosplenomegaly. Laboratory investigation upon admission revealed hyperimmunoglobulinemia and hyperchylomlcronemia. After the administration of penicillin, the chylomicronemia ceased, but an increase of very low density lipoprotein fraction was observed. As the infant recovered, all the laboratory findings returned to normal. Hyperchylomicronemia was attributed to hyperimmunoglobulinemia. Absorption of immunoglobulins to lipoproteins can inhibit lipoprotein lipase activity. The increase in the very low density lipoprotein fraction was probably caused by the increase in serum lipoprotein production and the decrease in lipoprotein clearance that are frequently seen in patients with infectious diseases.