Biomedical subjects

S Pee

Publications and source records attributed to S Pee.

4 recordsLinked to original sources

PubMed2004

Biopsy-proven childhood glomerulonephritis in Johor.

BACKGROUND: There has been no published study of biopsy-proven childhood glomerulonephritis in Malaysia. OBJECTIVES: To determine the pattern of childhood glomerulonephritis in Johor, Malaysia from a histopathological perspective and the various indications used for renal biopsy in children. MATERIALS AND METHODS: Retrospective study was done of all renal biopsies from children under 16 years of age, received in Sultanah Aminah Hospital, Johor between 1994 and 2001. The histopathological findings were reviewed to determine the pattern of biopsy-proven glomerulonephritis. The indications for biopsy, mode of therapy given after biopsy and the clinical outcome were studied. RESULTS: 122 adequate biopsies were received, 9 children had repeat biopsies. Of the 113 biopsies, minimal change disease formed the most common histopathological diagnosis (40.7%) while lupus nephritis formed the most common secondary glomerulonephritis (23.0%). The main indications for biopsy were nephrotic syndrome (50.8%), lupus nephritis (25.4%) and renal impairment (13.1%). The mode of therapy was changed in 59.8% of the children. Of 106 patients followed-up, 84 children were found to have normal renal function in remission or on treatment. 4 patients developed chronic renal impairment and 16 reached end stage renal disease. Five of the 16 children with end stage disease had since died while 11 were on renal replacement therapy. Another 2 patients died of other complications. CONCLUSIONS: The pattern of childhood GN in our study tended to reflect the more severe renal parenchymal diseases in children and those requiring more aggressive treatment. This was because of our criteria of selection (indication) for renal biopsy. Renal biopsy where performed appropriately in selected children may not only be a useful investigative tool for histological diagnosis and prognosis but may help clinicians plan the optimal therapy for these children.

Adolescent↗

PubMed2000

The potential of various foods to serve as a carrier for micronutrient fortification, data from remote areas in Indonesia.

OBJECTIVE: To estimate the potential of various industrially produced foods, to serve as a carrier for micronutrient fortification based on the frequency of their consumption in different socio-economic strata; to determine the role of fortified instant noodles as a source of micronutrients; to assess the contribution of plant foods, animal foods and fortified foods to vitamin A intake. SETTING: A survey was conducted in rural South Sulawesi and urban South Kalimantan between November 1996 and January 1997. SUBJECTS: Households (1500 in South Sulawesi; 2112 in South Kalimantan) were selected randomly by multi-stage cluster sampling. From each household, data were collected from the mother and her youngest child (0-5 y). DATA COLLECTION: Mothers were interviewed on various topics, including socio-economic status, food consumption, receipt of high-dose vitamin A capsules, health and nutritional status. RESULTS: Monosodium glutamate and salt were consumed daily in almost all households in both areas, and consumption was not associated with socio-economic status. Instant noodles were consumed in nearly all households in both areas, but consumption of fortified noodles was related to socio-economic status; it was highest among households of government employees and private investors, and lowest among farmers and share-croppers. Vegetables were the most important source of vitamin A in rural South Sulawesi, while foods of animal origin were the most important source in urban South Kalimantan. CONCLUSIONS: The results support double or triple fortification of salt and/or monosodium glutamate with iodine, vitamin A and/or iron. Efforts to overcome associated technical and logistical difficulties are urgently needed. SPONSORSHIP: Opportunities for Micronutrient Interventions (OMNI); United States Agency for International Development (USAID). European Journal of Clinical Nutrition (2000) 54, 822-827

Adult↗

PubMed1994

New algorithms to increase the initial rate response in a minute volume rate adaptive pacemaker.

BACKGROUND: Minute volume is a truly physiological sensor for rate adaptive pacing that correlates with metabolic expenditure throughout the range of physical activity. Criticism has centered on the slow initial response compared to less physiological sensors. A new algorithm, consisting of rate augmentation factor and programmable speed of response, has been incorporated in the 1206 META III pacemaker generator and was designed to improve the rate response at lower levels of exertions. Rate augmentation factor increases the programmed rate response factor by 3, 6, or 10 when set to low, medium, or high, respectively; this augmentation lasting to 50% of the maximum programmed rate. Response time can be programmed to medium or fast. METHODS: Nine patients were studied during the first 3 minutes of an exercise test (Bruce protocol) in a single blind manner. The pacemaker generator was randomly programmed with rate augmentation factor at off, low, or high and speed of response to medium or fast, giving six possible combinations. Heart rates were recorded continuously for the duration of the test and until resting heart rate was achieved during recovery. The test was repeated until all six combinations had been tested. RESULTS: During exercise significant differences appeared in response time from 30 seconds onward. Fast response and rate augmentation factor contributed to an improved rate response with greatest speed of response seen with fast response time and high rate augmentation factor. During recovery decreases in recovery time were seen with fast response time but rate augmentation factor prolonged recovery. CONCLUSIONS: Rate augmentation factor improves initial rate response in the early stages of exercise. Fast response gives an improved time to initial rate increase and shortens the duration of inappropriate postexercise tachycardia. These features improve the pattern of response of the minute ventilation sensor.

Aged↗

PubMedDate not supplied

Lupus nephritis in children in Malaysia.

OBJECTIVES: To determine the pattern of renal histology, clinical outcome of children with lupus nephritis and to identify any associated risk factors predicting renal failure in these children. METHODS: Retrospectively, 27 children under 16 years of age with lupus nephritis who had renal biopsies done at Sultanah Aminah Hospital Johor, Malaysia from 1994 to 2002 were studied. The renal histology was graded according to WHO classification system (1982). The medical records, laboratory data and the clinical outcome of the patients were studied. RESULTS: There were 24 cases of WHO Class IV, two cases of WHO Class II and a case of WHO Class V. Twenty children were in the good renal outcome group while six children progressed into the poor renal outcome group and required renal replacement. One child was lost to follow-up. All six children in the poor renal outcome group had WHO Class IV histology. The 5-year patient and renal survival rates were 84% and 75%, respectively. Age, sex, activity and chronicity indices in the renal histology, anaemia, elevated serum creatinine, depressed levels of C3 and C4, heavy proteinuria or presence of urinary active sediments were not associated with progression to renal failure. CONCLUSIONS: Presently, children with lupus nephritis appeared to have better patient and renal survival rates. Assessment of renal histology in these children was important for diagnosis, treatment and probably prognosis. In this study, there was a 25% incidence of loss of renal function over 5 years in children with WHO Class IV renal histology.

Adolescent↗