• Title/Summary/Keyword: Infants and Children

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Fibrinolytic (Thrombolytic) Therapy for Post Intraventricular Hemorrhagic Hydrocephalus in Preterm Infants

  • Young Soo Park
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.263-273
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    • 2023
  • While the survival rate of preterm infants has increased dramatically over the last few decades, intraventricular hemorrhage and subsequent hydrocephalus remain major unsolved problems in neonatal intensive care. Once intraventricular hemorrhage occurs, severe neurological sequelae are inevitable. Treatment of this complicated pathology and achievement of favorable neurofunctional outcomes in fragile infants are crucial challenges for pediatric neurosurgeons. Fibrinolytic therapy, which chemically dissolves hematoma, is a promising and useful treatment method. In this paper, the historical background of fibrinolytic therapy for post-intraventricular hemorrhagic hydrocephalus in preterm infants is reviewed and a recent method of fibrinolytic therapy using urokinase is introduced.

Effect of severe neonatal morbidities on long term outcome in extremely low birthweight infants

  • Koo, Kyo-Yeon;Kim, Jeong-Eun;Lee, Soon-Min;NamGung, Ran;Park, Min-Soo;Park, Kook-In;Lee, Chul
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.694-700
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    • 2010
  • Purpose: To assess the validity of individual and combined prognostic effects of severe bronchopulmonary dysplasia (BPD), brain injury, retinopathy of prematurity (ROP), and parenteral nutrition associated cholestasis(PNAC). Methods: We retrospectively analyzed the medical records of 80 extremely low birthweight (ELBW) infants admitted to the neonatal intensive care unit (NICU) of the Severance Children's Hospital, and who survived to a postmenstrual age of 36 weeks. We analyzed the relationship between 4 neonatal morbidities (severe BPD, severe brain injury, severe ROP, and severe PNAC) and poor outcome. Poor outcome indicated death after a postmenstrual age of 36 weeks or survival with neurosensory impairment (cerebral palsy, delayed development, hearing loss, or blindness) between 18 and 24 months of corrected age. Results: Each neonatal morbidity correlated with poor outcome on univariate analysis. Multiple logistic regression analysis revealed that the odds ratios (OR) were 4.9 (95% confidence interval [CI], 1.0-22.6; $P$=0.044) for severe BPD, 13.2 (3.0-57.3; $P$<.001) for severe brain injury, 5.3 (1.6-18.1; $P$=0.007) for severe ROP, and 3.4 (0.5-22.7; $P$=0.215) for severe PNAC. Severe BPD, brain injury, and ROP were significantly correlated with poor outcome, but not severe PNAC. By increasing the morbidity count, the rate of poor outcome was significantly increased (OR 5.2; 95% CI, 2.2-11.9; $P$<.001). In infants free of the above-mentioned morbidities, the rate of poor outcome was 9%, while the corresponding rates in infants with 1, 2, and more than 3 neonatal morbidities were 46%, 69%, and 100%, respectively. Conclusion: In ELBW infants 3 common neonatal mornidifies, severe BPD, brain injury and ROP, strongly predicts the risk of poor outcome.

Weaning Food Practice and Assessment in Children with Iron Deficiency Anemia (철 결핍 빈혈 영.유아의 수유 형태 및 이유 지식 평가)

  • Kim, Boo-Young;Choi, Eun-Hye;Kang, Sung-Kil;Jun, Yong-Hoon;Hong, Young-Jin;Kim, Soon-Ki
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.215-220
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    • 2009
  • Purpose: Recently, the favorable merits of breast feeding have received widespread attention and the number of breast feeding children is increasing. We investigated the weaning practices between breast feeding infants and non-breast feeding infants with respect to iron deficiency anemia (IDA). Methods: Between March 2006 and January 2009, we surveyed 70 parents, the children of whom had been medically diagnosed with IDA, and 140 parents, the children of whom did not have IDA, about how they feed their children and how much they know about the weaning process. The infants and children were 6∼36 months of age and attended the Inha University hospital. Results: IDA patients started weaning later than non-IDA patients. Also, breast feeding in IDA patients was more frequent than in non-IDA patients (82% vs. 30%). The breast feeding group began weaning at approximately 6.4 months of age, which was statistically meaningfully compared to non-breast feeding infants. There were no differences in knowledge between the two groups of parents. Conclusion: According to our research, we assume that if weaning begins at 6 months, we cannot supply sufficient iron to meet the infant's needs, which increase sharply around 6 months of age because of depletion of stored iron. Thus, infants need to initiate weaning from breast feeding at 4 months of age to furnish an ample amount of iron or take iron-containing supplements. These methods would be expected to prevent IDA in breast feeding infants.

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Immunization of preterm and low birth weight infant (미숙아와 저출생체중아의 예방접종)

  • Park, Su-Eun
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.14-17
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    • 2006
  • Infants who are born prematurely or with low birth weight should be immunized at the same postnatal chronologic age. They should receive BCG, DTaP, IPV vaccines according to the same recommended schedule as full term infants. Hepatitis B vaccine schedule is modified when hepatitis B vaccine is administered a infant with birth weight less than 2,000 g. The recommended standard dose of each vaccine should be administered. Proportion of children experiencing vaccine-related adverse events dose not differ between full-term and preterm infants. Immunization with routinely recommended childhood vaccines is safe for preterm and low birth weight infants.

Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up

  • Kono, Yumi
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.313-321
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    • 2021
  • Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

Vitamin D status and childhood health

  • Shin, Youn Ho;Shin, Hye Jung;Lee, Yong-Jae
    • Clinical and Experimental Pediatrics
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    • v.56 no.10
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    • pp.417-423
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    • 2013
  • Vitamin D is an essential component of bone and mineral metabolism; its deficiency causes growth retardation and skeletal deformities in children and osteomalacia and osteoporosis in adults. Hypovitaminosis D (vitamin D insufficiency or deficiency) is observed not only in adults but also in infants, children, and adolescents. Previous studies suggest that sufficient serum vitamin D levels should be maintained in order to enhance normal calcification of the growth plate and bone mineralization. Moreover, emerging evidence supports an association between 25-hydroxyvitamin D (25[OH]D) levels and immune function, respiratory diseases, obesity, metabolic syndrome, insulin resistance, infection, allergy, cancers, and cardiovascular diseases in pediatric and adolescent populations. The risk factors for vitamin D insufficiency or deficiency in the pediatric population are season (winter), insufficient time spent outdoors, ethnicity (non-white), older age, more advanced stage of puberty, obesity, low milk consumption, low socioeconomic status, and female gender. It is recommended that all infants, children, and adolescents have a minimum daily intake of 400 IU ($10{\mu}g$) of vitamin D. Since the vitamin D status of the newborn is highly related to maternal vitamin D levels, optimal vitamin D levels in the mother during pregnancy should be maintained. In conclusion, given the important role of vitamin D in childhood health, more time spent in outdoor activity (for sunlight exposure) and vitamin D supplementation may be necessary for optimal health in infants, children, and adolescents.

A Comparative Study on the Sizing Systems of the Infants and Children's Swim-suit (유유아 수영복의 치수체계 비교 연구)

  • Yi Kyong-Hwa;Jung Hae Sun
    • Journal of the Korean Society of Clothing and Textiles
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    • v.29 no.1 s.139
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    • pp.1-12
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    • 2005
  • This study was to suggest a feasible sizing system of infants and children's swim-suits. The basic body dimensions were selected after surveying the swimsuit manufacturers. The control dimensions and the secondary dimensions were taken from the 1997 National Anthropometric Survey data for the establishment of the sizing system. While in the current market swimsuit sizes were generally measured by the hip circumference for boys, and the bust and hip circumference for girls, the height was selected in this study as the control dimension because the height is well recognized by the customers and the KS standards specify the height to be the control dimension for infant's and children's wear. In the new sizing system of this study, the height was a control dimension, and hip was selected as a secondary dimension for boys. and bust and hip were selected as secondary dimensions for girls. Conclusively, in this study we suggest 12 sizes in case of 5cm height interval by the KS sizing system and 7 sizes in case of loom height interval by the current market sizing system, based on the height as a control dimension, for a standard swim-suit sizing system for infants and children.

Pediatric Mechanical Circulatory Support

  • Wilmot, Ivan;Lorts, Angela;Morales, David
    • Journal of Chest Surgery
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    • v.46 no.6
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    • pp.391-401
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    • 2013
  • Mechanical circulatory support (MCS) in the pediatric heart failure population has a limited history especially for infants, and neonates. It has been increasingly recognized that there is a rapidly expanding population of children diagnosed and living with heart failure. This expanding population has resulted in increasing numbers of children with medically resistant end-stage heart failure. The traditional therapy for these children has been heart transplantation. However, children with heart failure unlike adults do not have symptoms until they present with end-stage heart failure and therefore, cannot safely wait for transplantation. Many of these children were bridged to heart transplantation utilizing extracorporeal membranous oxygenation as a bridge to transplant which has yielded poor results. As such, industry, clinicians, and the government have refocused interest in developing increasing numbers of MCS options for children living with heart failure as a bridge to transplantation and as a chronic therapy. In this review, we discuss MCS options for short and long-term support that are currently available for infants and children with end-stage heart failure.

Association of body weight and urinary tract infections during infancy: a nationwide comparative matched cohort study

  • Peong Gang Park;Ji Hyun Kim;Yo Han Ahn;Hee Gyung Kang
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.111-116
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    • 2023
  • Purpose: This article was to investigate the association between urinary tract infections (UTIs) and high weight status in infancy. Methods: We conducted a nationwide matched cohort study from January 2018 to December 2020 using data from the Korean National Health Insurance System and the Korean National Health Screening Program for Infants and Children. We analyzed the association between UTI diagnosis codes and high weight status (which was defined as being in the 90th percentile or higher of weight-for-age). Results: We found that 22.8% of infants with UTIs exhibited high weight status, compared to 20.0% of non-UTI infants (P<0.001). Per our multivariable analyses, the adjusted odds ratio for high weight status was 1.09 (95% confidence interval, 1.06-1.13). Conclusions: UTI in the first 12 months of life was associated with a weight-for-age percentile of ≥90. Our findings corroborate those of previous single-center studies and emphasize the importance of careful monitoring for this at-risk group.