Clinical, laboratory, and radiologic characteristics of confirmed avian influenza (H5N1).

This was a cross sectional study to determine the clinical, laboratory and radiologic characteristics of confirmed avian influenza (AI) (H5N1) infection among children and adults. This study was conducted at Sulianti Saroso Infectious Diseases Hospital (SS-IDH), Jakarta among subjects confirmed to have AI infection hospitalized during September 2005 to August 2010. The proportion of confirmed AI patients was 33 out of 321 suspected and probable cases (10.2%). Of 26 subjects analyzed (7 subjects was excluded due to loss of or incomplete medical records), the median ages were 7 years and 25 years in children and adults, respectively (range 1 - 39 years). Prominent clinical features were respiratory symptoms [productive cough (13/13 children; 12/13 adults), dyspnea (12/13 children; 13/13 adults)], and fever (12/13 children; 12/13 adults). Leukopenia was found in 9 subjects in each group. Four children and 7 adults had lymphopenia, while thrombocytopenia was found in 7 children and 10 adults. Two children had an increased ALT, while most adults had an increased AST (10/13) and/or ALT (8/13). Bilateral infiltrates found in most subjects on chest x-ray who had clinical deterioration. Of the 3 children who survived out of 13 children with AI, they all had less severe clinical features and no central nervous system involvement, lymphopenia, thrombocytopenia, or increased creatinine level. None of the adults survived.

Risk factors of obstructive sleep apnea syndrome in obese early adolescents: a prediction model using scoring system.

AIM: to obtain the OSAS prevalence and risk factors of OSAS in obese early adolescents and to create a scoring system based on risk factors for diagnosing OSAS. METHODS: an observational study in Jakarta, November 2007 until December 2008 on obese adolescents aged 10-12 years with snoring. Subjects underwent clinical examination, lung function test, paranasal sinus X-ray, and polisomnography. Measured outcomes were diagnosis of OSAS; sensitivity, specificity, predictive values, and likelihood ratios of a scoring system based on risk factors. RESULTS: the prevalence of OSAS in obese early adolescents is 38.2% using AHI cut-off point of ≥3 on PSG. Tonsillar hypertrophy, adenoid hypertrophy, and neck circumference were the main risk factors. Scoring system was designed based on these results: OS= T + A + NC; OS= OSAS score; T= tonsil hypertrophy (≥T3 scored 1,

Intestinal parasitic infection of immunocompromised children with diarrhoea: clinical profile and therapeutic response.

BACKGROUND: Parasitic gastrointestinal infections have been variably reported among immunocompromised adults while data on children have been limited. This prospective cross-sectional study aimed to assess the clinical profile of intestinal parasitic infections among immunocompromised children with diarrhoea and their treatment response. METHODOLOGY: Two freshly voided stool samples taken for two consecutive days were examined by direct and formalin-ether concentrated smears. Modified Ziehl-Neelsen staining was used to detect Cryptosporidium, Isospora belli, and Cyclospora cayetanensis. Blastocystis hominis was identified using in vitro culture. Subjects positive for stool parasite(s) received standard therapy according to the aetiology and were evaluated afterward. RESULTS: Forty-two subjects from Jakarta, Indonesia were included in this study, mostly aged one to five years (78%) and HIV infected (52%). Parasites were found in 24/42 (57%) subjects in which B. hominis comprised the largest proportion (23/24 = 96%). Cryptosporidium was identified in two subjects who were HIV infected with CD4 percentages of < 15%. No helminth infestations were found. Parasites were most frequently found in preschool age children (16/23), in those with recurrent or watery diarrhoea (23/24 and 14/18, respectively), and in HIV subjects not receiving antiretrovirals (16/22). Of 13 subjects evaluated for response to a 10-day metronidazole course for B. hominis infection, seven achieved clinical remission and nine had their parasites eradicated. CONCLUSIONS: The prevalence of intestinal parasitic infection in immunocompromised children with persistent and/or recurrent diarrhoea is moderately high and dominated by B. hominis infection. Clinical remission and parasite eradication can be achieved in B. hominis infection treated with metronidazole.