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Y Pongprot

Publications and source records attributed to Y Pongprot.

2 recordsLinked to original sources
PubMed2006

Management and outcome of intravenous gammaglobulin-resistant Kawasaki disease.

INTRODUCTION: This study aimed to determine the prevalence and risk of intravenous gammaglobulin (IVIG)-resistant Kawasaki disease (KD) and report the outcome of treatment in patients with persistent or recurrent fever. METHODS: 70 KD patients, who received IVIG treatment (2 g/kg) at a tertiary care hospital from January 1995 to June 2004, were retrospectively reviewed. RESULTS: Nine (13 percent) of the 70 patients failed to respond to initial treatment with IVIG. The patients who did not respond to IVIG had higher erythrocyte sedimentation rate (ESR) (104 versus 74 mm/h; p-value is 0.003), longer total days of fever (14.4 +/- 3.8 versus 9.2 +/- 2.3 days; p-value is 0.003) and higher initial coronary artery lesions (CAL) (7 of 9 [77.7 percent] versus 10 of 61 [16.3 percent]; p-value is 0.001) than those who responded to initial treatment. Seven of the nine patients who were retreated with IVIG (2 g/kg) responded to the second dose. The remaining two patients (two of nine, 22 percent) had persistent fever, which subsided after two to three doses of pulse intravenous methylprednisolone. At two months follow-up, IVIG-resistant patients had higher CAL by echocardiogram than IVIG-responsive patients (33 percent versus 3.2 percent, p-value is less than 0.05). Two IVIG-resistant KD patients had delayed diagnosis and developed giant aneurysms. CONCLUSION: Patients with high ESR had increased risk of IVIG-resistant KD. IVIG-resistant Kawasaki patients had a higher prevalence of CAL at the acute phase and two months after onset.

Adolescent↗
PubMed1994

Cardiac function in malnourished children.

The cardiovascular status of severely malnourished children was characterized before, during, and after nutritional rehabilitation. In most children with third-degree malnutrition, cardiac mass was decreased on admission to the hospital and recovered subsequent to nutritional therapy. All children had echocardiographic and Doppler measurements indicative of impaired ventricular function which significantly improved during the course of hospitalization, as evidenced in part by the change in fractional shortening (P = 0.015), mean velocity of circumferential fiber shortening (P = 0.038), and systolic time interval (P = 0.030). We conclude that children with primary third-degree malnutrition not only have cardiac muscle wasting, but also have inherent ventricular dysfunction as the result of severe malnutrition that responds to nutritional therapy. Particular care with fluid administration is imperative in the first week of therapy, when heart function is the most compromised.

Child, Preschool↗