Be careful ... There Metropolis Dengue Virus

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Wednesday, January 27, 2010 | 8:04 pm
TEMPO Interactive, Surabaya-Be careful and be aware of symptoms of dengue fever if a family member affected. Because, currently there is a new virus variant of this disease. Especially if you frequently move from one city to another.

Tropical disease expert from Dr. Soetomo, Surabaya, Prof. Dr. Soegeng Soegijanto, SpA (K), tells of a study of the Institute of Tropical Disease, Airlangga University, Surabaya, a new variant of dengue virus is more virulent.

He said, research conducted since 2004 was conducted by collecting all of Dengue virus in the big cities. Starting from Jakarta, Surabaya, Solo, Yogyakarta, Semarang, Malang, Manado, Medan, as well as several other areas in Indonesia.

The result, he said, the DB virus that attacks the people in the big city was different. Moreover, he said, if the patient has the experience to go out the country such as Japan or the U.S.. DB virus that had attacked was also different from people who never go abroad. "The virus is then we agree with the name of the virus metropolis," said Soegijanto on Tuesday.

According to him, the symptoms of the virus DB Metropolis is very unique. Patients, he said, might not suffer the heat of summer but sometimes up and down two to three days with high platelet. However, the platelet count can suddenly went down instantly. "This phenomenon is almost impossible to predict regular doctor."

Karennya, he called on the doctors could do with more thorough examination of the patient. "If you need to immediately do blood tests do not let this virus attacked the heart," he said. "Physicians should be alert to monitor the state of patients for 24 hours."

At Dr Soetomo own, he said, had often receive this type of dengue fever patients. "Usually the patient referral," he said.

According to her, usually those who usually come and we monitor and lower the doctor for 24 hours.

sources web tempointeraktif.com/hg/kesehatan/2010/01/27/brk 0.20100127 to 221,628, id.html

Urinary Tract Infection (UTI)2

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Diagnosis

Infants or children under 2 years old with fever without source looks sick, antibiotics are given and urine samples were taken for culture by suprapubic aspiration or kateter.1 suprapubic aspiration is to take direct urine from the bladder with a needle. Possible contamination of the urine obtained by both methods is very small so both ways is the most reliable.

However, if a baby or child under 2 years with fever did not seem seriously ill, suprapubic aspiration or catheterization is sometimes considered berlebihan.1, 3 In this condition, urine sampling can be done in a way that is not invasive, for example:

• In the child who is old enough, can be done taking the urine mid-stream.3
* In infants or toddlers, it can be done taking the urine with the urine mid-stream urine container or bag attached to the perineum.3, 4

Urine sampling in this manner has a low risk of contamination if before making the perineum is cleaned thoroughly urine, urine collector bags are released immediately after the urine was obtained, and the stocks quickly diproses.1 In young women, the perineum should be cleaned from front to back with some sort of gauze soaked in warm water without antiseptik.3 If you can not directly be processed, the stocks should be stored in a temperature of 40. Preparations that have been stored up to 48 hours can still be used for the culture, but can not be used for the microscopic examination for cells that have been damaged.

Performed on urine samples were:

* Culture: Kultur (culture: breeding microorganisms) that will get rid of negative diagnosis ISK.1 While on a positive culture, urine sampling process must be observed. If a positive culture came from suprapubic aspiration or catheterization, the result is considered correct. However, if a positive culture was obtained from the urine collector bags, need to be confirmed by catheterization or suprapubic aspiration.
* Urinalysis: the most important components of urinalysis in UTI are leukocyte esterase, nitrites, and microscopic examination of leukocytes and bacteria. But there is no urinalysis component that can replace the importance of culture so that culture remains an imperative to diagnose ISK.1, 3

According to AAP, the number of bacterial colonies grown in culture for a positive, can be categorized as follows: 1

UTI diagnostic criteria

Likelihood of taking the urine of infected colonies (%)

Suprapubic aspiration of Gram-negative: whatever> 99%
Gram-positive:> a few thousand> 99%

Catheterization> 95% 105
Most likely an infection 104-105
103-104 doubt, repeat
<103 Possible infections not

Mid-stream / sac
Boys> 104 likely infection
Three daughters dosage 105 95%
2 105 90% stocks
1 105 80% stocks
5 × 104-105 doubt, repeat
104-5 × 104 + symptoms: doubt, repeat
- Symptoms: infection unlikely
<104>

Several parties have different restrictions regarding this criterion. For example the Royal Children's Hospital in Australia who use the 103 as a restriction of infection in urine samples obtained by kateterisasi.4 While on urine samples obtained from mid-stream, 108 in one stock is considered positive, and between 105-108 shows the initial infection and the need for re-examination .

Handling

In child two months - two years on suspicion of UTI and looked ill, antibiotics can be given parenterally (parenteral: intravenous) .1 Nursing at the hospital indicated if there are symptoms of sepsis or bacteremia (bacteremia: bacteria spread throughout the body via the circulatory ). Some parties indicated hospitalization and parenteral antibiotic use in children under 6 bulan.4

While on sick children who do not seem severe, antibiotics are generally given orally (drink). Some antibiotics that can be used are: 1.3

* Amoxicillin 20-40 mg / kg / day in three doses. Approximately 50% of UTI-causing bacteria resistant to Amoxicillin. But these drugs can still be given to UTI by bacteria sensitive to it.
* Co-trimoxazole or trimethoprim 6-12 mg trimethoprim / kg / day in two doses. Most of the ICS would show improvement with cotrimoxazole. Research indicates a greater cure rate in treatment with cotrimoxazole compared to Amoxicillin.
* Cephalosporin such as cefixime or cephalexin. Cephalexin roughly as effective as cotrimoxazole, but more expensive and has a broad spectrum so that it can interfere with normal intestinal bacteria or cause the growth of fungi (Candida sp.) In girls.
* Co-amoxiclav is used in UTIs with bacteria that were resistant to cotrimoxazole. The price is also more expensive than cotrimoxazole or cephalexin.
* Drugs such as nalidixic acid or nitrofurantoin not be used in children who feared having renal involvement in UTI. In addition nitrofurantoin are also more expensive than cotrimoxazole and has side effects such as nausea and vomiting.

Length of antibiotic treatment in general is the seventh day of UTI infections akut.3 While there are those who recommend 10-14 days, but given the long time it gives a greater possibility for the occurrence of resistance, the disruption of normal bacteria in the intestines and vagina, and cause candidiasis.

5 Selain itu juga tidak ada perbedaan berarti dalam kegagalan pengobatan antara kedua metode tersebut.6 Sehingga saat ini sebagian pihak menilai bahwa pemberian antibiotik jangka waktu pendek dapat dilakukan pada ISK tanpa komplikasi." onmouseover="this.style.backgroundColor='#ebeff9'" onmouseout="this.style.backgroundColor='#fff'">Giving antibiotics in the short term (<5> 5 In addition, there was no significant difference in treatment failure between the two methods tersebut.6 So when this part of some considered that the short-term antibiotic use can be made on the UTI without complications.

While treatment is generally carried out by parenteral cephalosporin such as ceftriaxone 75 mg / kg every 24 hours. Some parties choose gentamicin 7.5 mg / kg per 24 hours and benzylpenicillin at 50 mg / kg per 6 hours for children over one month

Besides antibiotics, treatment can be done to reduce such symptoms are fever-lowering drugs if diperlukan.3 other adults used for UTIs, are generally not recommended to be given to children.

If no improvement within 2 days after treatment, urine samples should be re-captured and re-checked ulang.1 culture after 2 days of treatment are generally not required if the improvement obtained and cultured bacteria previously sensitive to the antibiotics given. If the sensitivity of bacteria to antibiotics is granted or not conducted a test of sensitivity / resistance before, then repeat cultures performed after 2 days of treatment.

Continued Examination

After treatment with antibiotics is completed and the urine is sterile, made further investigation in children with ISK.1, three follow-up examination is the following:

* Ultrasonography kidneys, ureters, and bladder: This check is performed on all children with UTI as soon as possible.
* DMSA scan: This test is mainly to see the function of the urinary tract. DMSA scan is still debated the age restriction. However, usually done in children under 5 years with abnormal ultrasound results. Generally carried out two months after the episode of UTI to give a time improvement of the urinary tract. While waiting to do this inspection, several parties suggested a low dose of antibiotic.
* Cystogram: This is an examination of the bladder is also still debated the age restriction. But generally performed in children under 1 year or children with the results of ultrasound or DMSA abnormalities.

Examinations was performed earlier if there is no improvement after two days of antibiotic.

Other Matters Relating to UTI

Vur (vesico ureteral reflux) is the most common abnormality found on examination of this disorder happen lanjutan.1 The widening of the ureter that can continue to cause kidney damage. In children under 1 year with UTI, Vur can reach 50%. Vur there are various kinds of degrees, from the most mild to severe.

Recurrent UTI. UTI can be repeated once in 20% boys and 30% of girls, or more than once at 4% boys and 8% of children perempuan.3 own definition of recurrent UTIs are two or more UTIs in a period of six months .2 recurrent UTIs can lead to hypertension or renal failure kronik.3 Providing long-term antibiotics to prevent the recurrence of UTI did not have reasonable grounds. However, if a child has occurred or Vur recurrent UTIs, some parties advocated granting long-term low-dose antibiotics.

Source

* Practice Parameter: The Diagnosis, Treatment, and Evaluation of the Initial Urinary Tract Infection in Febrile Infants and Young Children. Pediatrics Vol. No. 103. 4 April 1999, pp. 843-852. Available from http://aappolicy.aappublications.org/cgi/content/full/pediatrics; 103/4/843
* Ahmed SM, Swedlund SK. Evaluation and Treatment of Urinary Tract Infections in Children. American Family Physician Vol 57 No 7 April 1998. Available from http://www.aafp.org/afp/980401ap/ahmed2.html
* Prodigy Guidance - Urinary tract infection - children available from http://www.prodigy.nhs.uk/guidance.asp?gt=UTI% 20 -% 20children
* Urinary Tract Infection Guidelines available from http://www.rch.org.au/clinicalguide/cpg.cfm?doc_id=5241
* Michael M, Hodson EM, Craig JC, Martin S, Moyer VA. Short versus standard duration oral antibiotic therapy for acute urinary tract infection in children (Cochrane Review). The Cochrane Library, Issue 3, 2005. Available from http://www.update-software.com/abstracts/ab003966.htm

Williams GJ, Lee A, Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children (Cochrane Review). The Cochrane Library, Issue 3, 2005. Available from http://www.update-software.com/abstracts/ab003966.htm

dr. Nurul H Itqiyah
sources web milissehat.web.id /? p = 30

Urinary Tract Infection (UTI)

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Urinary Tract Infection (UTI) in infants and small children is a situation that needs to be observed for 5% of sufferers show only a very vague symptoms with the risk of kidney damage greater than children who had more besar.1 And this damage can lead to hypertension or declining renal function.

Definition and prevalence

UTI is the presence of bacteria in the urine accompanied by symptoms infeksi.2 There also defines UTI as a symptom of infection with the pathogenic microorganisms (pathogenic: causing disease) in the urine, urethra (the urethra: a channel that connects the bladder to the outside world), bladder, or ginjal.3

UTI can occur in 5% of girls and boys 1-2% laki.2 Genesis UTI in newborns of low birth weight to reach 10-100 times higher compared to infants of normal birth weight (0.1 to 1%) . Before the age of one year, UTI occurs more frequently in boys. While thereafter, most UTIs occur in girls. For example, in pre-school age children where UTI in women reached 0.8%, while in men only 0.2%. And this ratio continues to increase so that at school age, the incidence of UTI in girls 30 times higher than in boys. And the boys who were circumcised, the risk of UTI decreased to 1/5-1/20 of a boy who did not disunat.1

At age 2 months - 2 years, 5% of children with UTI had fever without source of infection from history and examination fisik.1 Most of the ICS with a single symptom of this fever occurred in girls.

Causes and Risk Factors

* Escherichia coli is the most common cause in children, up to 80% .2 In newborns (0-28 days), infection is mediated by blood flow. Whereas after that age, generally occur with increasing UTI bacteria into the urinary tract.
Staphylococcus saprophyticus *
* Proteus mirabilis. In addition to causing infection, the bacteria release substances that can facilitate the formation of stones in the urinary tract.
* Other microorganisms that cause UTI are some bacteria that commonly infect the digestive tract and Candida albicans, a fungus that commonly infects patients with catheters (catheters: a kind of hose) on the bladder channel, low immunity, diabetes mellitus, or patients in the antibiotic therapy.

Most UTIs are not associated with risk factors for recurrent UTI tertentu.3 however, needs to consider the possible risk factors such as:

* Abnormal function or urinary tract anatomical abnormalities
* Impaired bladder emptying (Incomplete bladder emptying)
* Constipation
* Operation of urinary tract
* Low body immunity

Symptom

Symptoms that may appear on UTI in children is not very specific, and as mentioned earlier, many are only accompanied by fever as gejala.1, 3

* The newborn (0-28 days): fever, yellow prolonged, failure to thrive, do not want to breastfeed
* Infants: fever, refusing feeds, vomiting, diarrhea
* Children: fever, pain while urinating, frequent urination, blood in the urine, the urine is cloudy or foul-smelling, pain in the area above the pubic bone, wet (after the previous stop bed-wetting)

Urinary infections in children

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Urinary tract infection (UTI) is a disease that is often found in children, in addition to gastrointestinal infection. UTI is an important disease in children, because it causes unpleasant symptoms in children.

If not tackled seriously, UTI can cause complications such as urinary tract stones, hypertension, or kidney failure requiring dialysis or transplant actions kidney. Therefore, we should recognize UTI can be arranged as early as possible in order to avoid inadequate governance with a worse result.

UTI can be about all people, starting a newborn to adults, both male and female. UTI is more common in infants or children dtemukan small compared with adults. In infants up to age three months, UTI is more often in men than women, but then more often on women than men.

UTI occurs as a result of the entry of bacteria into the urinary tract. Usually the bacteria come from feces or rectum, into the lower urinary tract, or urethra, then up into the bladder and can be up to the kidney. Germs can also enter the urinary tract through the bloodstream from other places who widened, there is a urinary tract obstruction, enlarged bladder and others. Just like any other infectious disease, UTI will more readily occur in children with malnutrition or a child's immune system is low. Children who experience frequent constipation or restrain restrain urine (pee) can also be at risk of UTI.

Symptoms:
- Sometimes no symptoms, and diagnosed with kidney failure after complications occur. In newborns, the symptoms are not typical, so it is often not thought of, for example, unstable temperature (fever or a temperature lower than normal), look sick, inflammable or Irritable, not drinking, vomiting, diarrhea, flatulence, urine color appear reddish or yellow.

In infants over one month, can include fever, reddish urine, easily aroused, seemed ill, decreased appetite, vomiting, diarrhea, flatulence or appear yellow. At preschool age children or school, UTI symptoms may include fever with or without chills, pain in the waist area, bermih time pain, urinary leak a little but often, feeling like urinating, urine, cloudy or reddish color.

Treatment:
If there is suspicion of UTI, it is necessary laboratory examination, ie examination of the urine, urine routine and culture. Urinalysis examination results may be known, whereas the urine culture results may take one week.

There are three important things are wont to do if a patient already diagnosed with UTI sebagaii: first, to eradicate infection: second, detect, prevent, and treat recurrent infections and the third detecting anatomical and functional abnormalities of urinary tract and overcome if there

To combat infection, the drug is given disinfectant (antimicrobial or antibiotic) for 7-10 days. To the extent possible germ killer drug is given in accordance with the results of sensitivity tests of germs that are known from the results of urine cultures. To detect recurrent infection, need to do a urine culture examination on a regular basis, and if there is infection, the infection is treated with appropriate antibiotics.

To detect the anatomical and functional abnormalities of urinary tract, typically doctors perform a more thorough physical examination and imaging examination was performed if necessary / radiological examinations such as ultrasound or x-ray of the kidneys and urinary tract. If there are abnormalities in the urinary tract, then the administration of then adjusted with abnormalities found in whether or not to require surgical intervention. IDAI.or.id
source web-anak.com dr, dr. Maharani Blog

Dengue Hemorrhagic Fever (DHF) 5

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Tip's How to Cope Dengue Hemorrhagic Fever

Early diagnosis
* Home-like other diseases, it is necessary to alert
* Please support tools (laboratory)
* Note the sign of the gravity
* Need to monitor regularly: symptoms and laboratory

Medical
* Early disease: fever problem, resulting in anti-fever drugs
* Expect plenty of fluids
* Replacement of fluid (drinking & IV)
* Other drugs depending on complications arising

Special Attention
* Fever 3 days or more without cause
* Drugs down the heat: paracetamol, not asetosal
* Drink a lot, kind of taste
* Do not check blood without doctor's approval
* Blood tests should be at fever day 3 or more
* No need to panic if the child still wants to drink a lot
* If there are cases of DHF in the same house, each child with fever was treated immediately

source web dr-anak.com/demam-berdarah-dengue.html
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