1.Comparison of various methods of detection of Hypoxemia and Correlation of Hypoxemia with clinical features among pediatric patients 3 months to 5 years old with community-acquired Pneumonia at a tertiary hospital emergency room
Francesca Mae T. Pantig ; Salvacion R. Gatchalian
Pediatric Infectious Disease Society of the Philippines Journal 2019;20(1):24-38
Introduction:
Pulse oximetry is frequently utilized as a rapid, non-invasive, point-of-care alternative to arterial blood gas analysis in measuring oxygen saturation of children with pneumonia.
Objectives:
To compare portable fingertip pulse oximetry saturation (SpO2PF), handheld pulse oximetry saturation (SpO2H) and arterial oxygen saturation (SaO2) in detection of hypoxemia, and correlate hypoxemia with clinical features in children with pneumonia.
Methodology:
This was a prospective, observational, cross-sectional study involving patients 3 months to 5 years old with pneumonia. Oxygen saturation was measured using a portable fingertip pulse oximeter, a handheld pulse oximeter, and arterial blood gas analysis.
Results:
Eighty-six children were included. SpO2 PF underestimated oxygen levels by 0.126% (95% CI -0.240 to 0.491), while SpO2H underestimated it by 0.323% (95% CI -0.075 to 0.721). Between portable and handheld readings, the mean difference was 0.198% (95% CI -0.089 to 0.484). Across the three methods, limits of agreement ranged from -3.388 to +4.035%. There was no statistically significant difference in variance among the three measurements. Children with tachypnea (cOR 2.623, 95% CI 1.06 – 6.48, p = 0.037), difficulty breathing (cOR 6.316, 95% CI 1.96 – 20.34, p = 0.002), and subcostal retractions (cOR 2.842, 95% CI 1.05 to 7.69, p = 0.040) were more likely to have hypoxemia.
Conclusion
Pulse oximetry closely correlates with arterial blood gas analysis within acceptable limits of agreement and with no significant differences in variance among measurements. Difficulty breathing, tachypnea and subcostal retractions were significantly more likely to be observed in hypoxemic children.
Oximetry
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Hypoxia
2.Profile of community-acquired Methicill in Resistant Staphylococcus Aureus Skin and Soft-Tissue infections among children admitted at the Philipine General Hospital
Pauline T. Reyes-Solis ; Salvacion R. Gatchalian
Pediatric Infectious Disease Society of the Philippines Journal 2016;17(1):35-44
Abstract:
CA-MRSA infection is a global concern. It is important to determine the local prevalence of CA-MRSA skin and soft-tissue infection as this information will provide a more accurate and rational basis for empiric treatment, improve management and outcomes in patients, and reduce the economic burden associated with failed treatment. This study was conducted to determine the clinical profile and prevalence of CA-MRSA skin and soft tissue infections among pediatric patients admitted at the Philippine General Hospital.
Methods:
A prospective, observational study was performed involving all pediatric patients admitted at U-PGH for skin and soft tissue infections from September to December 2012. Demographic profile, clinical characteristics of patients, results of laboratory examinations, the outcome of treatment were described and summarized. Risk factors for acquisition of MRSA were also determined. Period-prevalence was computed.
Results:
There were 25 children admitted for SSTIs, 16 have positive cultures and 62.5% of these had CA-MRSA. The majority were male children younger than 5 years old without identifiable risk factors. infections presented as solitary masses and cellulitis usually at the head and neck area. isolates were taken from aspirates during incision and drainage. Invasive infections were seen 3 patients. The length of hospital stay, type of antibiotics used and surgery performed was variable. All patients were discharge well and there were no mortalities. The period prevalence of CA-MRSA among children with SSTI was 0.36.
Conclusion
CA-MRSA as a cause of SSTIs in Filipino children is an emerging concern, especially in very young patients even without risk factors. management of SSTI’s should include incision and drainage of abcesses and prompt submission of aspirates for culture and antibiotic sensitivity testing. The period prevalence of pediatric patients with SSTI is high among hospitalized patients. Empiric antibiotics with MRSA coverage such as clindamycin and vancomycin should be considered clinical situations wherein MRSA is deemed likely.
Methicillin-Resistant Staphylococcus aureus
3.Profile of pediatric patients with dengue fever/dengue hemorrhagic fever over a five-year period (2000-2004)
Jonathan G. Lim ; Salvacion R. Gatchalian ; Ma. Rosario Z. Capeding
Pediatric Infectious Disease Society of the Philippines Journal 2010;11(1):26-34
Objectives: This study was conducted to determine the clinico-demographic profile of pediatric patients who were admitted for dengue infection at the Research Institute for Tropical Medicine (RITM) from 2000 to 2004.
Methods: This is a retrospective, descriptive study. Charts of patients who were less than 19 years of age and were admitted at the RITM due to confirmed dengue (using paired dengue HI titer results) were reviewed.
Conclusion: The clinico-demographic profile of patients involved in the study was very similar to that of other studies done, both locally and abroad. By using Spearman's correlation of ranks, the study showed that there was no significant relationship between the severity of dengue infection based on the World Health Organization (WHO) Grade and whether it was a primary or secondary infection with r=.018, p-value=.025.
Human
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Male
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Female
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Adolescent
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Child
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Child Preschool
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Infant
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DENGUE
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DENGUE HEMORRHAGIC FEVER