• Safety and Health at Work
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• 제9권1호
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• pp.101-108
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• 2018

Background: Work and work environment have a critical influence on adolescent workers' health. They are subjected to more risks than adults. The aim of this study is to examine psychological health outcomes in adolescent workers in the areas of depression, somatization, anxiety, hostility, and negative self-concept, and to investigate any related factors. Methods: This is a descriptive and cross-sectional study. Research samples were collected from adolescent workers between 15 and 18 years old attending a 1-day mandatory education course at vocational training centers, working 5 days per week in small enterprises. Data were collected using the following instruments: Brief Symptom Inventory, Multidimensional Scale of Perceived Social Support, and Descriptive Characteristics of Children's Assessment Form. Results: The investigation covers 837 young workers, of whom 675 were males and 162 were females. The majority of the families had low incomes (68.1%). Overall, 33.5% of the adolescents had been hospitalized because of health problems. Their average weekly working hours were $78.1{\pm}10.7$. Almost 50% of adolescent workers scored above the mean average in the Brief Symptom Inventory, indicating serious pschological health symptoms. Those who scored high for hostility, depression, negative self-concept, anxiety, and somatization were between 45.4% and 48.9% of the sample. Logistic regression analysis was conducted to determine the underlying factors: a perception of "feeling very bad" health conditions was 2.07-fold whereas the rate of "no annual leave" was 0.73-fold, and both were found to be effective on psychological problems. Conclusion: In this study, it seems likely that psychological health problems are the result of multiple adverse factors including working conditions, annual leave, and health considerations.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권4호
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• pp.244-251
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• 2017

Purpose: We evaluated the efficacy and safety of combined oral and enema therapy using polyethylene glycol (PEG) 3350 with electrolyte solution for disimpaction in hospitalized children. Methods: We retrospectively studied 28 children having functional constipation who received inpatient treatment between 2008 and 2016. The amount of oral PEG 3350 electrolyte solution administered was 50-70 mL/kg/d (PEG 3350, 3-4.1 g/kg/d), and an enema solution was administered 1-2 times a day as a single dose of 15-25 mL/kg (PEG 3350, 0.975-1.625 g/kg/d). A colon transit time (CTT) test based on the Metcalf protocol was performed in some patients. Results: Administration of oral and enema doses of PEG 3350 electrolyte solution showed $2.1{\pm}0.3$ times and $2.9{\pm}0.4$ times, respectively. After disimpaction, the frequency of defecation increased from $2.2{\pm}0.3$ per week to once a day ($1.1{\pm}0.1$ per day). The number of patients who complained of abdominal pain was reduced from 15 (53.6%) to 4 (14.3%). Before hospitalization, nine patients underwent a CTT test, and 5 of 9 patients (55.6%) were classified as belonging to a group showing abnormalities. And in some patients, mild adverse effects were noted. We examined electrolytes and osmolality before and after disimpaction in 16 of 28 patients, and no abnormalities were noted. Conclusion: In terms of therapeutic efficacy and safety, combined oral and enema therapy using high-dose PEG 3350 with electrolytes is considered superior to conventional oral monotherapy or combined oral and enema therapy on an outpatient basis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.369-376
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• 2019

Purpose: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. Methods: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. Results: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and $22.8{\mu}g/mL$, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. Conclusion: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권5호
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• pp.431-440
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• 2019

Purpose: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. Conclusion: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.

• 고신대학교 의과대학 학술지
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• 제33권2호
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• pp.150-158
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• 2018

Objectives: Although Campylobacter is the main cause for bacterial acute gastroenteritis (AGE), there has been no notable clinical research into it, especially for Korean children. In this study, we share our experience of clinical, laboratory and image findings with Campylobacter AGE. Methods: Between May 2013 and June 2016, children diagnosed as having Campylobacter AGE were retrospectively enrolled in our study. Campylobacter AGE was considered diagnosed when a patient had symptoms of bacterial AGE and a positive Campylobacter result in stool using multiplex PCR. Results: Among 539 patients with suspected bacterial AGE, 31 (5.8%) patients had a positive result for Campylobacter. The average age of the 31 patients was $10.2{\pm}5.0$ years with a range between 1.1 and 16.9 years. Eighteen (58%) of the total patients were hospitalized between June and August. Diarrhea (93.5%), abdominal pain (83%) and fever (83%) were common symptoms. For 20 patients (65%), diarrhea lasted for less than three days, and fever lasted for 2.1 days on average. Among the 20 patients subjected to imaging studies, 12 patients (60%) showed bowel wall thickening on the right side of colon. In blood tests of 30 patients, 22 (73%) and 29 (97%) patients exhibited leukocytosis and elevated C-reactive protein, respectively. During treatment for Campylobacter AGE, prediagnostic empirical antibiotics were used for 6 (19%) patients. All patients recovered without complications. Conclusions: Among the children with suspected bacterial AGE, 5.8% had a positive result on Campylobacter in stool using multiplex PCR. Therefore, we observe that Campylobacter AGE should be considered in school-age children who have diarrhea, fever, and abdominal pain.

• Clinical and Experimental Pediatrics
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• 제64권12호
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• pp.652-660
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• 2021

Background: Viral load and shedding duration are highly associated with the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, limited studies have reported on viral load or shedding in children and adolescents infected with sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Purpose: This study aimed to investigate the natural course of viral load in asymptomatic or mild pediatric cases. Methods: Thirty-one children (<18 years) with confirmed SARS-CoV-2 infection were hospitalized and enrolled in this study. Viral loads were evaluated in nasopharyngeal swab samples using real-time reverse transcription polymerase chain reaction (E, RdRp, N genes). cycle threshold (Ct) values were measured when patients met the clinical criteria to be released from quarantine. Results: The mean age of the patients was 9.8 years, 18 (58%) had mild disease, and 13 (42%) were asymptomatic. Most children were infected by adult family members, most commonly by their mothers. The most common symptoms were fever and sputum (26%), followed by cough and runny nose. Nine patients (29%) had a high or intermediate viral load (Ct value≤30) when they had no clinical symptoms. Viral load showed no difference between symptomatic and asymptomatic patients. Viral rebounds were found in 15 cases (48%), which contributed to prolonged viral detection. The mean duration of viral detection was 25.6 days. Viral loads were significantly lower in patients with viral rebounds than in those with no rebound (E, P=0.003; RdRp, P=0.01; N, P=0.02). Conclusion: Our study showed that many pediatric patients with coronavirus disease 2019 (COVID-19) experienced viral rebound and showed viral detection for more than 3 weeks. Further studies are needed to investigate the relationship between viral rebound and infectiousness in COVID-19.

• Childhood Kidney Diseases
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• 제26권1호
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• pp.46-51
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• 2022

Purpose: Delta neutrophil index (DNI) indicates immature granulocytes in peripheral blood and has been confirmed to be effective as a prognostic factor for neonatal sepsis. Also, it has been reported to have diagnostic value in acute pyelonephritis and in predicting vesicoureteral reflux (VUR) in the infant. We conducted the study to verify whether DNI is also helpful in the entire pediatric age group with febrile urinary tract infection (UTI). Methods: Medical records of children hospitalized for febrile UTIs were analyzed retrospectively. All subjects underwent kidney ultrasound and voiding cystourethrography. In the group with and without VUR, we compared sex and age, and the following laboratory values: the white blood cell count, neutrophil, polymorphonuclear leucocyte, eosinophil, hemoglobin, platelet count, C-reactive protein, DNI value, and the finding of ultrasound. Results: A total of 315 patients (163 males and 152 females; range, 0-127 months) were eligible, and 41 patients (13%) had VUR. As a result of univariate analysis, the white blood cell count, neutrophil, DNI, and ultrasonic abnormalities were high in the reflux group, and the hemoglobin and lymphocyte fraction values were low. The value of DNI and the abnormal ultrasound were significantly higher in the reflux group on the multivariate analysis. The area under the curve value of the receiver operating curve was higher in DNI (0.640; 95% confidence interval, 0.536-0.744; P=0.004), and the DNI cutoff value for VUR prediction was 1.85%. Conclusions: We identified that ultrasound findings and DNI values were helpful predictors of VUR in pediatric febrile UTIs.

• Childhood Kidney Diseases
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• 제27권1호
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• pp.34-39
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• 2023

Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children's Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.

• Child Health Nursing Research
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• 제5권1호
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• pp.48-58
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• 1999

The purpose of this study was to determine the most accurate technique measuring the apical pulse rate, using three counting duration 15, 30 and 60 seconds, and two methods start ‘0’ and start ‘1’. The instrument used in the study was the EKG monitor, stethoscope and stopwatch. Data was analyzed by utilizing SPSSWIN program. General characteristics of the subjects were analyzed by frequency, percentile, mean, SD. The subject of this research is made up of 46 children and 20 nurses. The children were infants, & under the age of 5. They were hospitalised in PICU & NICU in 2 tertiary hospitals in seoul from Jan. 1. 1998 to Sep. 10. 1998. The measurement of starting 1 & measurement of starting ‘0’ used the T-test to find out the measurement error. Apical pulse duration of 15, 30, 60 seconds were used to find out measurement error, the measurement error depend on experience of Nurse were analyzed by using ANOVA. The result of this study are as follows. 1. When comparing the starting poin of apical pulse 0&1, starting with 1 the measurement error is less, but not statiscally significant. 2. When counting the apical pulse by 15, 30,60 sec. ; 60 seconds counting duration was more accurate, but not statistically significant. 3. The mean of measure error ; Group under 100/min, is 10.33 ; from 100 re 119/min, is 8.30 ; from 120 to 139/min, is 4.76 ; from 140 to 159/min, is 6.09 ; above 160, is 17.83. The differences of these groups are statistically significant. When 60sec were counted, under 140/min the mean of measurement error is 3.4. Also when 30 seconds were counted from 140/min to 159/min the measurement error is 7.14, above 160/min the measurement error is 16.4. That measurement mean is the smallest than the other durations. During the 15 sec. count the measurement error was the largest of them all. 4. By the experience of the nurses, the apical pulse count measurement error was discovered. Under a year experience this measurement error was the largest(11.09), 1 year to under 3 years, the error is the smallest(4.86). 3 year to under 6 years the error is 8.33, 5 years above the error is 6.11 but this is not statistical significant. Under a year experience when counting 15, 30, 60 seconds the error is the largest. The group of the nurses from a year to under 3 years, the measurement error is the smallest of all the groups. The result of the study is to determine the technique measuring the apical pulse rate, Hargest (1974), starting point ‘0’ is not proved. When the pulse rate increases the 30 sec measurement rate is accurate. Under 140/min the 60 sec measurement rate is the most accurate. Depending on the nurses experiences, there is a variable difference to the apical pulse rate measurement. Especially new nurses training courses should enforce the children’s pulse rate count and the basic vital signs.

• Child Health Nursing Research
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• 제20권2호
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• pp.87-95
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• 2014

목적 본 연구는 산욕초기 미숙아 어머니의 산후우울과 예측요인을 파악하기 위한 서술적 조사연구이다. 방법 연구대상자는 일 지역 두 곳의 신생아중환자실에 미숙아가 입원 중인 미숙아 어머니로 분만 후 2-3주이며, 배우자가 있는 기혼여성 101명을 대상으로 하였다. 자료수집기간은 2010년 6월부터 2011년 1월까지였다. 연구도구는 산후우울(Edinburgh Postnatal Depression Scale), 산전 우울, 주관적 아기 건강상태, 의료인 지지, 배우자 지지 측정도구를 사용하였다. 자료는 SPSS win 18.0 program을 이용하여 기술통계, ttest, ${\chi}^2$-test, multiple logistic regression으로 분석하였다. 결과 산욕초기 미숙아 어머니의 산후우울 발생률은 81.6%였으며, 산후우울 예측요인은 분만방법(OR, 5.57; 95% CI, 1.25-24.77), 주관적 아기 건강상태(OR, 0.34; 95% CI, 0.16-0.70) 및 의료인 지지(OR, 0.52; 95% CI, 0.28-0.97) 등으로 나타났다. 결론 대부분의 미숙아 어머니들은 산욕초기 산후우울을 나타내었기 때문에 조기 중재를 목적으로 한 스크리닝이 필요하다. 또한 산후우울은 제왕절개로 분만하였으며, 주관적으로 아기 건강상태가 불건강하다고 인식할수록 그리고 의료인 지지가 낮을수록 발생비율이 높게 나타났다. 따라서 의료인들은 미숙아 어머니들이 제왕절개로 분만한 경우 더욱 관심을 기울어야 하며, 주관적으로 자신의 아기를 부정적으로 인식하지 않도록 도와야 한다.