• 제목/요약/키워드: High risk Infant

검색결과 128건 처리시간 0.031초

Clinical characteristics and serum N-terminal pro-brain natriuretic peptide as a diagnostic marker of Kawasaki disease in infants younger than 3 months of age

  • Bae, Hyun Kyung;Lee, Do Kyung;Kwon, Jung Hyun;Kim, Hae Soon;Sohn, Sejung;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • 제57권8호
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    • pp.357-362
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    • 2014
  • Purpose: The incidence of Kawasaki disease (KD) is rare in young infants (less than 3 months of age), who present with only a few symptoms that fulfill the clinical diagnostic criteria. The diagnosis for KD can therefore be delayed, leading to a high risk of cardiac complications. We examined the clinical characteristics and measured the serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels of these patients for assessing its value in the early detection of KD. Methods: We retrospectively reviewed the data of young infants diagnosed with KD from 2004 to 2012. The control group included 20 hospitalized febrile patients. Laboratory data, including NT-proBNP were obtained for each patient in both groups. Results: Incomplete KD was observed in 21/24 patients (87.5%). The mean fever duration on admission was $1.36{\pm}1.0$ days in the KD group. Common symptoms included erythema at the site of Bacille Calmette-Guerin inoculation (70.8%), skin rash (50.0%), changes of oropharyngeal mucosa (29.1%), and cervical lymphadenopathy (20.8%). The mean number of major diagnostic criteria fulfilled was $2.8{\pm}1.4$. Five KD patients (20.8%) had only one symptom matching these criteria. The incidence of coronary artery complications was 12.5%. The mean serum NT-proBNP level in the acute phase, in the KD and control groups, were $4,159{\pm}3,714pg/mL$ and $957{\pm}902pg/mL$, respectively, which decreased significantly in the convalescent phase. Conclusion: Incomplete KD was observed in 87.5% patients. Serum NT- proBNP might be a valuable biomarker for the early detection of KD in febrile infants aged <3 months.

A study on the factors affecting the follow-up participation in birth cohorts

  • Park, Bohyun;Choi, Eun Jeung;Ha, Eunhee;Choi, Jong Hyuk;Kim, Yangho;Hong, Yun-Chul;Ha, Mina;Park, Hyesook
    • Environmental Analysis Health and Toxicology
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    • 제31권
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    • pp.23.1-23.6
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    • 2016
  • Objectives A stable follow-up participation rate is a very important factor for validity in a cohort study. This study analyzed the factors that affect the participation rate at one hospital-based birth cohort in South Korean. Methods The participants were recruited from the Mothers' and Children's Environmental Health study between 2006 and 2010. The analysis targeted 1751 mothers who participated in a birth cohort. We conducted analyses of general characteristics during pregnancy and those of infants at birth that affect the participation rate of the 6-month follow-up survey. Results The participation rate for the 6-month follow-up survey was 60.4%. The participation rate in the follow-up of the subsequent period decreased within a 5% to 10% range compared to the number of subjects. The participation rate of premature infants was 16.9% lower than that of a full-term infant (52.6% vs. 69.5%). Analysis showed a 16.7% difference between the participation rate of low-birthweight infants in follow-ups (53.7%) and the participation rate of infants with normal weight (70.4%). The participation rate of mothers who were employed during pregnancy was significantly lower for the 6-month follow-up compared to the participation rate of mothers who were unemployed during pregnancy. Conclusions In this study, factors such as premature birth, low-birthweight, and the employment status of the mother during pregnancy affected the participation rate of the follow-up survey for the birth cohort at six months. A specific strategy is needed to encourage survey participation for the high risk groups in the follow-ups.

Clinical Factors Affecting Lipid Metabolism and Optimal Dose of Heparin in Preterm Infants on Parenteral Nutrition

  • Lim, Mi Sun;Choi, Chang Won;Kim, Beyong Il;Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권2호
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    • pp.116-122
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    • 2013
  • Purpose: Preterm infants on parenteral nutrition are at a relatively high risk for hypertriglyceridemia because they have immature lipoprotein lipase activity. The purpose of this study was to analyze the clinical factors affecting lipid metabolism in preterm infants receiving parenteral nutrition and to evaluate the influence of intravenous heparin on serum triglycerides to determine the adequate heparin dose to prevent hypertriglyceridemia in preterm infants. Methods: A single-center retrospective review was conducted among preterm infants receiving parenteral nutrition between January 2006 and February 2011. In 75 patients, 110 determinations were performed within 28 days postnatal age. Demographic and clinical data, including laboratory parameters, the dose and the duration of lipid administration, and the amount of intravenous heparin, were analyzed. Results: Serum triglycerides were higher in the small for gestational age (SGA) infants than in the appropriate for gestational age infants ($185.5{\pm}134.9$ mg/dL vs. $126.9{\pm}101.9$ mg/dL, p=0.019). Birth weight, gestational age, and body weight were negatively correlated with serum triglyceride level (r=-0.289, p=0.002; r=-0.208, p=0.029; r=-0.287, p=0.002, respectively). The serum triglyceride level was statistically lower in preterm infants receiving 1 U/mL of heparin than in those receiving 0.5 U/mL heparin or no heparin. Conclusion: Preterm infants receiving parenteral nutrition, particularly SGA and extremely low birth weight infants, tend to have hypertriglyceridemia. Thus, administration of 1 U/mL of heparin rather than 0.5 U/mL or none may be helpful to prevent hypertriglyceridemia in preterm infants.

산후우울증에 대한 임상적 연구 (A Clinical Study on the Postpartum Depression)

  • 김락형;김수연;권보형
    • 동의신경정신과학회지
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    • 제11권2호
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    • pp.123-130
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    • 2000
  • Objectives: Postpartum depression(PPD) is a kind of serious problem which influences on the postpartum woman, her family and infant. It has been known to be caused by many factors and some depression scales have been used to assess the degree of PPD. Edinburgh Postpartum Depression Scale(EPDS) recently began to be used for screening for PPD.Methods: The subjects were 46 women who admitted for postpartum treatment in Oriental Hospital of Woosuk University from May 2000 to December 2000. In this study, we used EPDS and Beck Depression Inventory(BDI) to assess the degree of PPD, and we researched the related factors of PPD. Results: 13 women(28.3%) in the high risk group by EPDS and 7 women(15.2%) in depression - severe depression group by BDI were diagnosed as PPD among the 46 women. There was significant correlation between Epds score and BDI score. The mean score of EPDS was higher in normal delivery group than caesarean delivery group, higher in primiparae group than multiparae group, and higher in the group who delivered female infants than male infants. But there were not significant differences. And there was not significant correlation between EPDS score and age.Conclusions: These results suggest that PPD is quite frequent at postpartum period and it is necessary to treat for PPD. It is important for clinicians to pay attention to the related factors of PPD as well as to recognize and treat PPD.

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Efficacy and Safety of Soy Protein Based Formula in Atopic Dermatitis

  • Yeom, Kkot-Bo-Ra;Kim, Kyu-Han
    • Preventive Nutrition and Food Science
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    • 제16권3호
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    • pp.248-252
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    • 2011
  • Soy protein based formula (SPF) has been developed for infants who are at a high risk for atopic dermatitis (AD) and cow's milk protein allergy (CMA). We performed this study to evaluate the therapeutic efficacy and safety of SPF compared to conventional hydrolyzed cow's milk formula (hCMF) in the feeding of infants with AD and CMA. 38 infants (12 to 24 months of age) diagnosed with CMA and AD were randomized to receive either SPF or hCMF for 12 weeks. Follow-up was conducted at 4, 8 and 12 weeks. Growth parameters of the infants were evaluated during each visit. Clinical evaluations, including AD severity scores, pruritus, specific immunoglobulin E (IgE) (cow's milk protein and soy protein) levels of peripheral blood, were made at enrollment and week 12. Analysis was performed on the 32 infants (SPF: n=16, hCMF: n=16) who completed the 12-week intervention. Eczema area and severity index (EASI) scores, a measure of the severity of AD, and pruritus were significantly reduced after 12 weeks compared to enrollment in the both groups; however, the median changes for EASI scores and pruritus were not statistically different between the two groups. The growth parameters did not differ significantly between both groups at any assessed time point. This study suggests that SPF could be useful in decreasing the severity of AD without affecting infant growth status. Therefore SPF could provide an adequate and safe alternative to hCMF in treating infants with AD and CMA during the first 12 to 24 months of their life.

유아에서 영양섭취와 알레르기성 비염과의 관련성 - 2013년~2016년 국민건강영양조사 자료이용 - (Relation of Nutritional Intake and Allergic Rhinitis in Infants - Using the Korea National Health and Nutrition Examination Survey (KNHANES) 2013~2016 -)

  • 허은실;서보영
    • 대한지역사회영양학회지
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    • 제24권4호
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    • pp.321-330
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    • 2019
  • Objectives: This study examined the relationship between the presence of allergic rhinitis and the nutritional intake levels of Korean infants. Methods: The study involved a total of 1,214 infant subjects aged 1~5 months from the 2013~2016 KNHNES (Korea National Health and Nutrition Examination Survey). The Subjects were classified into two groups based on the presence of allergic rhinitis: Non-allergic rhinitis infants (NARI, n=1,088) and allergic rhinitis infants (ARI, n=126). The general characteristics and family history of allergies, nutrient intake status, nutrient supplement intake, and breast milk and baby food start period data of the two groups were compared. All statistical analyses accounted for the complex sampling design effect and sampling weights. Results: The mean age was 0.5 years old in the ARI group compared to the NARI group. In the residence, the rate of urban was higher in ARI. The family history revealed a significant difference between the two groups, particularly those of mothers rather than fathers. The nutrient intake levels were high in energy, phosphorus, sodium, potassium, iron, riboflavin, niacin, and polyunsaturated fatty acids. Breastfeeding was significantly higher in the ARI group than in the NARI group. The baby food start period was 0.3 months earlier in NARI group than in ARI group. The height, body weight, and birth weight were higher in ARI group than NARI group. The result of Odds ratio analysis showed that excess energy, protein, calcium, phosphorus, iron, riboflavin, and niacin intake increases the risk of allergic rhinitis. Conclusions: These results can be used as data to develop nutrition guidelines for allergic rhinitis infants.

The Bayley-III Adaptive Behavior and Social-Emotional Scales as Important Predictors of Later School-Age Outcomes of Children Born Preterm

  • Yun, Jungha;Kim, Ee-Kyung;Shin, Seung Han;Kim, Han-Suk;Lee, Jin A;Kim, Eun Sun;Jin, Hye Jeong
    • Neonatal Medicine
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    • 제25권4호
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    • pp.178-185
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    • 2018
  • Purpose: We aim to assess the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III), Adaptive Behavior (AB) and Social-Emotional (SE) scales at 18 to 24 months of corrected age (CA) to examine their associations with school-age cognitive and behavioral outcomes in children born preterm. Methods: Eighty-eight infants born with a very low birth weight (<1,500 g) or a gestational age of less than 32 weeks who were admitted to the neonatal intensive care unit from 2008 to 2009 were included. Of the 88 children who completed school-age tests at 6 to 8 years of age, 37 were assessed using the Bayley-III, including the AB and SE scales, at 18 to 24 months of CA. Correlation, cross-tabulation, and receiver operating characteristic analyses were performed to assess the longitudinal associations. Results: A significant association was observed between communication scores on the Bayley-III AB scale at 18 to 24 months of CA and the Korean version of the Wechsler Intelligence Scale for Children (K-WISC) full-scale intelligence quotient (FSIQ) at school age (r=0.531). The total behavior problem scores of the Korean version of the Child Behavior Checklist (K-CBCL) at school age were significantly negatively related to the Bayley-III SE and AB scales but not to the cognitive, language, or motor scales. Conclusion: Our findings encourage AB and SE assessments during the toddler stage and have important implications for the early identification of children in need of intervention and the establishment of guidelines for follow-up with high-risk infants.

Pathogenesis and Prevention of Intraventricular Hemorrhage in Preterm Infants

  • Pei-Chen Tsao
    • Journal of Korean Neurosurgical Society
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    • 제66권3호
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    • pp.228-238
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    • 2023
  • Intraventricular hemorrhage (IVH) is a serious concern for preterm infants and can predispose such infants to brain injury and poor neurodevelopmental outcomes. IVH is particularly common in preterm infants. Although advances in obstetric management and neonatal care have led to a lower mortality rate for preterm infants with IVH, the IVH-related morbidity rate in this population remains high. Therefore, the present review investigated the pathophysiology of IVH and the evidence related to interventions for prevention. The analysis of the pathophysiology of IVH was conducted with a focus on the factors associated with cerebral hemodynamics, vulnerabilities in the structure of cerebral vessels, and host or genetic predisposing factors. The findings presented in the literature indicate that fluctuations in cerebral blood flow, the presence of hemodynamic significant patent ductus arteriosus, arterial carbon dioxide tension, and impaired cerebral venous drainage; a vulnerable or fragile capillary network; and a genetic variant associated with a mechanism underlying IVH development may lead to preterm infants developing IVH. Therefore, strategies focused on antenatal management, such as routine corticosteroid administration and magnesium sulfate use; perinatal management, such as maternal transfer to a specialized center; and postnatal management, including pharmacological agent administration and circulatory management involving prevention of extreme blood pressure, hemodynamic significant patent ductus arteriosus management, and optimization of cardiac function, can lower the likelihood of IVH development in preterm infants. Incorporating neuroprotective care bundles into routine care for such infants may also reduce the likelihood of IVH development. The findings regarding the pathogenesis of IVH further indicate that cerebrovascular status and systemic hemodynamic changes must be analyzed and monitored in preterm infants and that individualized management strategies must be developed with consideration of the risk factors for and physiological status of each preterm infant.

선천성 심질환을 가진 3개월 소아에서 장기간의 체외 막형 산소화 보조 후 몸무게 차이가 큰 공여자-수용자간 심장 이식 (Transplantation of an Extremely Oversized Heart after. Prolonged Extracorporeal Membrane Oxygenation Assistance in a 3-month-old Infant with Congenital Heart Disease)

  • 조현진;서동만;장원경;박천수;김영휘
    • Journal of Chest Surgery
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    • 제42권5호
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    • pp.630-634
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    • 2009
  • International Society for Heart and Lung Transplantation (ISHLT)는 2007년 보고에서 선천성 심질환, 1세 미만의 나이, 이식 당시 체외 막형 산소화 보조가 심장 이식 후 사망의 유의한 위험 요소임을 보고하였으며, 몸무게 차이가 클 경우에도 사망의 위험도를 높인다고 하였다. 이 증례의 환아는 심한 좌심실 유출로 협착, 승모판 폐쇄 부전이 있어 Ross수술과 승모판 성형술을 시행하였으나 술 후 심한 좌심실 기능부전으로 체외 막형 산소화 보조를 적용하였다. 체외 막형 산소화 보조 30일이 경과한 생후 3개월 경 공여자-수용자간 몸무게 비가 4.42에 이르는 매우 큰 심장을 성공적으로 이식하였기에 이식의 기술적인 주요 사항을 문헌 고찰과 함께 보고하는 바이다.

청년창업기업의 창업초기 생존전략 : 중진공 청년전용자금 활용기업 사례 (Youth Startup Firms: A Case Study on the Survival Strategy for Creating Business Performance)

  • 이승창;임원호;서응교
    • 유통과학연구
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    • 제12권6호
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    • pp.81-88
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    • 2014
  • Purpose - Entrepreneurship promotion is emerging as an important economic growth agenda. However, in Korea, entrepreneurship has weakened because of the collapse of the venture bubbles of the 2000s and the global economic recession in 2008, which have induced the business community to choose stability over risk. The Korean government has been implementing several support projects to inspire and promote youth entrepreneurship through various means including financial assistance; however, the perpetuation rate of young entrepreneurship is still low as compared to advanced economies such as the US and EU. This case study focuses on the Youth Start-Up Business Support Program of the Small & Medium Business Corporation, and explores practical alternatives. Further, it aims to suggest managerial factors and a conceptual model for change management factors affecting the business performance creation of a startup company, based on the Small and medium Business Corporation's young venture startup fund. Research design, data, and methodology - Many studies examine the current progress and issues of startup firms, for example, a lack of systematic cultivation of entrepreneurship and startup business training, lack of commercialization funding for youth startup businesses, lack of mentoring, and inadequate infrastructure. From prior research, we address four factors, namely, personal managerial capabilities, innovative business model, sufficient cash flow, and social network, affecting startup companies' business performance. This study involved a sample survey of 200 young entrepreneurs to investigate casual relations between the four factors and business performance. A regression analysis was used to verify the hypotheses. Results - First, in relation to differences in the founder's personal characteristics, age, sales amount, and number of employees significantly impact business performance. Second, regarding the causal relation between the four factors for creating business performance, an innovative business model and social networking have supported the hypotheses, revealing that the more that a start-up founder has an innovative business model and social networking, the more the start-up firms are likely to have better performance (e.g., sales volume, employment, ROE, ROI, etc.). Although the founder's competency and sufficient cash flow have no significant relationship with business performance, the mean value was higher performance for high founder's competency and sufficient cash flow. Conclusions - This study provides basic data on policy support strategies of the Small and Medium Business Corporation, to help young entrepreneurs achieve their start-up business goals. It shows that young entrepreneurship startup firms should strive to explore ideas to satisfy customers' needs, and that changes in customer value and the continuous innovation of business model differentiation are required to actively respond to change management. Moreover, at the infant startup stage, they should activate social network programs to share information, thereby offsetting resource scarcity and managing business risk. Further, the establishment of a long-term vision and the implementation of training programs in related specific fields should be supported to strengthen founders' personal capabilities.