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Rodica Toganel

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Prophylaxis with Palivizumab in infants with congenital heart disease

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Prophylaxis with Palivizumab in infants with congenital heart disease

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ABSTRACT

Introduction. Human respiratory syncytial virus infections in children suffering from congenital heart disease is a primary cause of cardiac decompensation, which leads to frequent and prolonged hospitalizations. We will be sharing our department’s experience with utilizing Palivizumab in newborns and infants with hemodynamically significant congenital heart diseases.

Methods. According to recommendations made by immune prophylaxis guides regarding Palivizumab, 28 children with mean age 2,6 months hospitalized in the Cardiology Clinic II- Children, of the County Emergency Clinical Hospital in Tîrgu Mureş were included in a vaccination program between October 2010 and February 2012. The administered dose was 15 mg/kg (monthly intramuscular injection). Each child treated with Palivizumab was monitored in order to establish the hospitalization rate for respiratory infections, as well as detect any adverse reactions. A control group of 28 children, with a mean age of 4,3 months, with severe CHD was selected. The rate of respiratory infections was observed. The case group was monitored for 6 months after vaccination and the rate of bronchyolitis was observed.

Results. The hospitalization rate for respiratory infection was 3,57% in the case group, and 32% in the control group. Monitoring the side effects after vaccination showed no severe adverse reactions: 19% of the children developed subfebrility and slight anxiety and 4% developed fever and diarrhea 24 hours after administration.

Conclusion. The results show a favorable response to the vaccine, with minor side effects, an absence of hemodynamic decompensation at the time of administration, as well as a reduced number of human respiratory syncytial virus infections.

Key words: congenital heart disease, Palivizumab, infant

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PROFILAXIA CU PALIVIZUMAB LA SUGARII CU MALFORMATII CARDIACE CONGENITALE

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Revista Romana de PEDIATRIE | Volumul LXII, Nr. 2, An 2013
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Promoting Global Health

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PROFILAXIA CU PALIVIZUMAB LA SUGARII CU MALFORMATII CARDIACE CONGENITALE

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REZUMAT

Introducere. Infecţiile respiratorii cauzate de virusul sinciţial respirator la copiii cu malformaţii cardiace congenitale reprezintă o importantă cauză de decompensare, care determină spitalizări repetate, cu durată prelungită. Prezentăm experienţa centrului nostru privind utilizarea profilactică a Palivizumab la copiii sub 24 de luni, internaţi cu malformaţii cardiace congenitale semnificative hemodinamic. Material şi metodă. În conformitate cu recomandările ghidurilor privind profilaxia cu Palivizumab, 28 de copii cu vârsta medie de 2,6 luni, internaţi în Clinica Cardiologie II Copii a Spitalului Clinic Judeţean de Urgenţă Târgu-Mureş, au fost incluşi în programul de vaccinare, în perioada octombrie 2010 – februarie 2012. Pe perioada spitalizării s-au monitorizat parametrii hemodinamici, s-a notat orice reacţie adversă apărută, precum şi rata infecţiilor respiratorii. Părinţii au semnat un consimţământ informat privind acordul pentru vaccinare. A fost selectat un grup control care nu a beneficiat de vaccin (28 copii, vârsta medie 4,3 luni), urmărindu-se rata infecţiilor respiratorii pe perioada derulării programului. La lotul imunizat am monitorizat rata îmbolnăvirilor respiratorii 6 luni postimunizare. Rezultate. Rata îmbolnăvirilor respiratorii la lotul imunizat a fost de 3,57%, iar la lotul control 32%. Efectele secundare postvaccinare: 18% au prezentat subfebrilitate şi uşoară iritabilitate, iar 4% febră şi diaree la 24 de ore după administrare. La lotul imunizat nu au apărut decompensări hemodinamice. Concluzii. Efectele secundare postvaccinare au fost minore, nu au apărut decompensări hemodinamice, iar rata de îmbolnăvire postimunizare a fost redusă.

Cuvinte cheie: malformaţii cardiace congenitale, Palivizumab, sugar

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ASPECTELE EPIDEMIOLOGICE ALE MALFORMATIILOR CARDIACE CONGENITALE LA COPII SI IMPLICATIILE ACESTORA IN ELABORAREA UNUI REGISTRU CLINIC DE MONITORIZARE

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 4, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ASPECTELE EPIDEMIOLOGICE ALE MALFORMATIILOR CARDIACE CONGENITALE LA COPII SI IMPLICATIILE ACESTORA IN ELABORAREA UNUI REGISTRU CLINIC DE MONITORIZARE

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REZUMAT

Introducere. Cu o incidenţă estimată la nivel mondial de 6 în 1.000 de nou-născuţi, malformaţiile cardiace congenitale (MCC) sunt una dintre principalele cauze ale mortalităţii în primul an de viaţă. Principalele probleme în managementul malformaţiilor cardiace congenitale (MCC), în România, sunt lipsa de date care să descrie incidenţa reală la nivel populaţional, lipsa de standardizare în diagnosticul şi raportarea MCC la nivel naţional. În România, există doar încercări locale de a dezvolta un registru de malformaţii cardiace.

Obiective. Măsurarea şi analiza incidenţei MCC la copii în Centrul Pediatric Cardiovascular al Institutului de Urgenţă pentru Boli Cardiovasculare şi Transplant Tg. Mureş (IUBCvT) în vederea determinării ratei de înrolare, stabilirea formularului de înregistrare şi urmărire al Registrului Clinic de Monitorizare al MCC.

Material şi metodă. A fost realizat un studiu descriptiv retrospectiv al copiilor externaţi cu un diagnostic principal sau comorbiditate din categoria Q20-Q28 (Malformaţii cardiace congenitale – ICD 10 AM), în perioada 2008-2013, la nivelul Centrului Pediatric Cardiovascular al Institutului de Urgenţă pentru Boli Cardiovasculare şi Transplant Târgu-Mureş. Lotul de studiu a cuprins un număr de 839 de nou-născuţi externaţi din secţia Neonatologie a Spitalului Clinic Judeţean de Urgenţă Târgu-Mureş (SCJU), respectiv 4.423 de copii externaţi din IUBCvT.

Rezultate. Incidenţa MCC la nivelul nou-născuţilor externaţi din SCUJ a variat între 5,23% şi 11,47%. Din cei 839 nou-născuţi, 139 au fost operaţi în cadrul IUBCvT în primele 30 zile de viaţă. Cele mai frecvente malformaţii sunt Comunicaţie interauriculară (46,52%), Permeabilitatea canalului arterial (22,10%), Comunicaţia interventriculară (9,04%). Morbiditatea spitalizată pe grupe de boli la nivelul IUBCvT demonstrează ponderea ridicată a Comunicaţiei interventriculare (20,05%), a Comunicaţiei interauriculare (15,98%) şi a Permeabilităţii canalului arterial (13,05%). Din cei 1.255 de copii la care s-a intervenit chirurgical, cele mai frecvente intervenţii chirurgicale (17,93%) au fost pen tru Comunicaţie interauriculară.

Concluzii. Întocmirea unui Registru al MCC este importantă pentru depistarea, diagnosticul, monitorizarea şi instituirea unei atitudini terapeutice adecvate.

Cuvinte cheie: monotorizarea malformaţiilor cardiace congenitale, registru clinic, cardiologie

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EPIDEMIOLOGICAL ASPECTS OF CONGENITAL HEART MALFORMATIONS IN CHILDREN AND THEIR IMPLICATIONS IN DEVELOPING A CLINICAL MONITORING REGISTRY

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Revista Romana de PEDIATRIE | Volumul LXIII, Nr. 4, An 2014
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

EPIDEMIOLOGICAL ASPECTS OF CONGENITAL HEART MALFORMATIONS IN CHILDREN AND THEIR IMPLICATIONS IN DEVELOPING A CLINICAL MONITORING REGISTRY

, , , , and

ABSTRACT

Introduction. With an estimated incidence of 6 cases to 1000 births worldwide, congenital cardiac malformations (CHM) are one of the main causes of death during the fi rst year of life. The main issues regarding CHM management in Romania are the lack of data that describe the true incidence on population level, lack of standardized diagnosis and CHM reporting at national level. In Romania we see only local attempts at establishing such a CHM registry.

Objectives. Measuring and analysing the incidence of CHM in children within the Pediatric Cardiovascular center of the Emergency Cardiovascular and Transplant Institute in Targu Mures (IUBCvT) in order to determine de rate of enrollment, conturing the registration and follow-up form for CHM.

Material and methods. We have conducted a retrospective, descriptive study concerning children discharged between 2008-2013, with a main diagnosis or comorbidity belonging to the category Q20-Q28 (Congenital cardiac malformations – ICD 10 AM), belonging to the Pediatric Cardiovascular center of IUBCvT. The study group was made up of 839 new-borns discharged from the Neonatology clinic of the Mures County Emergency Clinical Hospital (SCJU) and 2181 children discharged from IUBCvT.

Results. The incidence of CHM in new-borns discharged from SCJU varied between 5.23% and 11.47%. Of the total 839 new-borns, 139 underwent surgery in the IUBCvT within the fi rst 30 days of life. The most frequent malformations found were interatrial communication (46.52%), persistent ductus arteriosus (22.10%), interventricular communication (9.04%). Disease group based morbidity within the IUBCvT demonstrates the large share of interventricular communication (20.05%), interatrial communication (15.98%) respectively of persistent ductus arteriosus (13.05%). Of the 1255 children that underwent surgery, the most frequent procedures (17.93%) were conducted for interatrial communication.

Conclusions. Establishing a CHM clinical registry is important for the screening, diagnosing, monitoring of congenital cardiac malformations as well as aiding in choosing the right treatment path.

Keywords: congenital cardiac malformations monitoring, clinical registry, cardiology

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