• Title/Summary/Keyword: Pediatric age

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Clinical Epidemiologic Profile of Rotavirus Infections in Korea (국내 로타바이러스 감염의 역학)

  • Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.15 no.1
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    • pp.5-11
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    • 2008
  • Primary rotavirus gastroenteritis infection usually occurs in infants under 2 years of age worldwide regardless of level of hygiene, quality of water, food or sanitation or type of behavior. In Korea, the disease mostly occurred in infants under 2 year old, and usually in late fall to early winter with the highest incidence shown in November until early 1990s. However, since then, relatively the age incidence of this infection has increased in children over 2 years old, and it has mainly occurred in late winter to early spring with the highest incidence shown between February and March. And rotavirus gastroenteritis serotypes varied year to year as well as varied by year within the same region in our country. The comparison of severity scores between age groups in Korea showed that severity score was lowest in infants less than 3 months and highest in infants more than 6 months and less than 12 months, and hospitalization period between age groups was longest in infants older than 3 months and less than 3 months and highest in infants more than 6 months and less than 12 months and less than 6 months. In this aspect, rotavirus vaccines should be given to infants less than 2 years of age in whom the incidence of rotavirus gastroenteritis is the highest, and vaccination should be ideally started before 3 months considering hospitalization period and severity of rotavirus gastroenteritis. However, It should be careful for the introduction of new rotavirus vaccine, and the effectiveness of rotavirus vaccines should be assessed by long-term post marketing surveillance. And we guess an multivalent vaccine may be an ideal rotavirus vaccine to prevent primary infection caused by variable rotavirus strains in Korea. In addition, clinical epidemiology studies on rotavirus gastroenteritis which evaluate the age and serotypes related severity should be continuously conducted in various regions.

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Clinical Characteristics of Celiac Disease and Dietary Adherence to Gluten-Free Diet among Saudi Children

  • Al Sarkhy, Ahmed;El Mouzan, Mohammad I.;Saeed, Elshazaly;Alanazi, Aziz;Alghamdi, Sharifa;Anil, Shirin;Assiri, Asaad
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.23-29
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    • 2015
  • Purpose: To describe the clinical characteristics of celiac disease (CD) among Saudi children and to determine the adherence rate to gluten free diet (GFD) and its determinant factors among them. Methods: A cross-sectional study was conducted, in which all the families registered in the Saudi Celiac Patients Support Group were sent an online survey. Only families with children 18 years of age and younger with biopsy-confirmed CD were included. Results: The median age of the 113 included children was 9.9 years, the median age at symptom onset was 5.5 years and the median age at diagnosis was 7 years, the median time between the presentation and the final diagnosis was 1 year. Sixty two of the involved children were females. Ninety two percent of the patients were symptomatic at the diagnosis while eight percent were asymptomatic. The commonest presenting symptoms included: chronic abdominal pain (59.3%), poor weight gain (54%), abdominal distention, gases, bloating (46.1%) and chronic diarrhea (41.6%). Sixty percent of the involved children were reported to be strictly adherent to GFD. Younger age at diagnosis and shorter duration since the diagnosis were associated with a better adherence rate. Conclusion: CD has similar clinical presentations among Saudi children compared to other parts of the ward; however, the adherence to GFD is relatively poor. Younger age at diagnosis and shorter duration since the diagnosis were associated with a better adherence rate.

Sonographic renal length and volume of normal Thai children versus their Chinese and Western counterparts

  • Rongviriyapanich, Chantima;Sakunchit, Thanarat;Sudla, Chirawat;Mungkung, Supamas;Pongnapang, Napapong;Yeong, Chai Hong
    • Clinical and Experimental Pediatrics
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    • v.63 no.12
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    • pp.491-498
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    • 2020
  • Background: Renal size is an important indicator in the diagnosis of renal diseases and urinary tract infections in children. Purpose: The purpose of this study is twofold. First, it aimed to measure the renal length and calculate the renal volume of normal Thai children using 2-dimensional ultrasonography (2D-US) and study their correlations with somatic parameters. Second, it aimed to compare the age-specific renal size of normal Thai children with the published data of their Western and Chinese counterparts. Methods: A total of 321 children (150 boys, 171 girls; age, 6-15 years) with a normal renal profile were prospectively recruited. All subjects underwent 2D-US by an experienced pediatric radiologist and the renal length, width, and depth were measured. Renal volume was calculated using the ellipsoid formula as recommended. The data were compared between the left and right kidneys, the sexes, and various somatic parameters. The age-specific renal lengths were compared using a nomogram derived from a Western cohort that is currently referred by many Thailand hospitals, while the renal volumes were compared with the published data of a Chinese cohort. Results: No statistically significant difference (P<0.05) was found between sexes or the right and left kidneys. The renal sizes had strong correlations with height, weight, body surface area, and age but not with body mass index. The renal length of the Thai children was moderately correlated (r=0.59) with that of the Western cohort, while the age-specific renal volume was significantly smaller (P<0.05) than that of the Chinese children. Conclusion: Therefore, we concluded that the age-specific renal length and volume obtained by 2D-US would vary between children in different regions and may not be suitably used as an international standard for diagnosis, although further studies may be needed to confirm our findings.

Growth Patterns of Indonesian Infants with Cow's Milk Allergy and Fed with Soy-Based Infant Formula

  • Setiabudiawan, Budi;Sitaresmi, Mei Neni;Sapartini, Gartika;Sumadiono, Sumadiono;Citraresmi, Endah;Sekartini, Rini;Putra, Azwin Mengindra;Jo, Juandy
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.3
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    • pp.316-324
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    • 2021
  • Purpose: The use of soy-based infant formula has increased widely in infants with cow's milk allergy (CMA). This study aimed to provide evidence on the growth pattern of CMA infants fed with soy-based infant formula in an Indonesian setting. Methods: A multi-site, intervention study was conducted among full-term and normal birth weight CMA infants. Within six months, the subjects were provided with a soy-based infant formula. Weight, height, and head circumference were measured at baseline, weeks 4, 8, 12, 16, 20, and 24. Adverse events were recorded by scoring atopic dermatitis and symptom-based clinical scores. Results: Based on the World Health Organization growth chart, we found that most of subjects had normal nutritional status for weight-for-age, length-for-age, weight-for-length, and head-circumference-for-age. There were statistically significant differences between baseline and end-line for weight-for-age, length-for-age, weight-for-length, and head circumference-for-age nutritional status. No allergic symptoms or intolerance toward soy formula were observed at the end of the intervention period. Conclusion: These results show that infants fed with soy-based infant formula have a normal pattern of growth.

Dental Consultations and Treatment Pattern of Pediatric Inpatient in Severance Hospital (세브란스 병원에 입원한 환자들의 소아치과 협진의뢰 내용 및 진료현황)

  • Song, Jihyeo;Lee, Koeun;Song, Je Seon;Kim, Seong-Oh;Lee, Jaeho;Choi, Hyung-jun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.2
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    • pp.200-208
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    • 2019
  • The purpose of this study was to analyze the dental consultation of pediatric inpatients to the department of pediatric dentistry in Yonsei University Severance Hospital, and to investigate the change in patterns. In 2017, 268 pediatric patients (384 cases) admitted to the Severance Hospital were referred to the department of pediatric dentistry. The mean age was 6.6 years, and most of the patients were referred from the Department of Pediatric Hematology Oncology and Rehabilitation Medicine. The chief complaints were as follows: oral examination (31%), dental caries (20%), oral pain (10%), tooth mobility (10%), pre-operative evaluation (9%) and others (20%). 41% of the patients received only oral examination without treatment. Dental caries were the most frequent dental diagnosis of the patients. 28% (111 cases) of patients received operative treatments, 22 cases were treated under general anesthesia. Oral health is closely related to systemic diseases, especially for hospitalized patients. Dental consultations should be encouraged for prevention and early appropriate treatments. For this purpose, it is necessary to establish a referral system and perform dental treatment under general anesthesia.

A clinical study on pediatric patients with fracture that visited oriental medicine center (한방병원에 내원한 소아 골절환자에 대한 임상적 고찰)

  • Chang, Gyu-Tae;Kim, Jang-Hyun;Baek, Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.1
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    • pp.1-9
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    • 2004
  • Objectives: The purpose of this study was clinical review of pediatric patients with fracture that visited oriental medicine center. Methods: In retrospective study, the pediatric patients, who were visited to oriental medicine center due to fracture, were classified by sex, age, fracture site, date of accident, injury mechanism, time of treatment, kind of treatment. Results and Conclusion: Total 32 patients were visited due to fracture from April 2001 to March 2004. Male Patients were 27, female were 5. In distribution of age, 10 year-old and 11 year-old were 40.7% of totality. In distribution of month, May was 10(31.3%), June was 6(18.8%), and March was 4(12.5%). There are more patients with fracture in spring than other season. In distribution of fracture site, foot was 15(46.9%), hand was 7(21.9%), ankle was 4(12.5%), upper extremity was 3(9.4%), clavicle was 2(6.3%), tibia was 1(3.1%). In distribution of injury mechanism, slip down was 23(71.9%), impaction 5(15.6%), fall down 3(19.4%), crushing injury 1(13.1%). In distribution of injury motive, soccer was 8(25.0%), basketball 4(12.5%), skating 3(9.4%), cycling 2(6.3%), sliding 1(3.1%), Tae-kwon-do 1(3.1%), other sports 5(15.6%), collision 1(3.1%), walking 2(6.3%), hit 3(9.4%), etc. 2(6.3%). In distribution of treatment account, one time was 23(71.9%), twice 3(9.4%), three times 2(6.3%), four times 2(6.3%), five times 2(6.3%). In distribution of treatment time, 1 week was 26(81.3%), 2 weeks 4(12.5%), 3 weeks 2(6.3%). In distribution of treatment kind, acupuncture treatment was 18(56.3%), negative cupping 7(21.9%), splint 13(40.6%), and other treatment(coban taping, medical patch, and so on) 5(15.6%), transfer 14(43.8%).

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Analysis of causes of injuries among children in Daegu, Korea

  • Ha, Geol;Jeon, Man-Joong;SaKong, Joon
    • Clinical and Experimental Pediatrics
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    • v.53 no.11
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    • pp.942-950
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    • 2010
  • Purpose: The purpose of this study was to determine the mechanisms and exact causes of injuries to children by analyzing the medical records of children who visited emergency medical centers. Methods: We reviewed the medical records of 7,114 pediatric patients (aged below 15 years) who visited the emergency care center (ECC) of a Yeungnam university hospital in Daegu between January 2007 and December 2009. Results: Among the pediatric patients who visited the ECC, 1,526 (27.2%) were admitted for injuries (boys, 979 [64.2%] and girls, 547 [35.8%]); the boy-to-girl ratio in this study population was 1.8:1. The proportion of boys was higher than that of girls over all age ranges, except for children aged less than 1 year. The highest incidence of injury due to slipping (20.5%) was noted in the 1-year-old group, and nearly half the total number of cases (49.3%) involved children who were under 4 years of age. Of the sites of injury, 999 involved the head and face (73.7%) and 134 involved the hand and wrist (9.9%). Seventy-one injuries (5.7%) occurred on the bed, 70 (5.6%) at the door, and 67 (5.3%) on the stairs. Of the approximately 250 types of injuries classified by cause, 17 accounted for 50.4% of all the injuries. Conclusion: The cause of injury could be attributed to approximately 20 causes in more than half the cases of pediatric injuries. A classification of the types of injuries and the development of appropriate preventive strategies can help avoid such injuries.

Higher Morbidity of Monogenic Inflammatory Bowel Disease Compared to the Adolescent Onset Inflammatory Bowel Disease

  • Kim, Kwang Yeon;Lee, Eun Joo;Kim, Ju Whi;Moon, Jin Soo;Jang, Ju Young;Yang, Hye Ran;Ko, Jae Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.1
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    • pp.34-42
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    • 2018
  • Purpose: Monogenic inflammatory bowel disease (IBD) patients do not respond to conventional therapy and are associated with a higher morbidity. We summarized the clinical characteristics of monogenic IBD patients and compared their clinical outcomes to that of non-monogenic IBD patients. Methods: We performed a retrospective cohort study of all children <18 years old who were diagnosed with IBD between 2005 and 2016. A total of 230 children were enrolled. Monogenic IBD was defined as a presentation age less than 6 years old with confirmation of a genetic disorder. We subdivided the groups into monogenic IBD (n=18), non-monogenic very early-onset IBD (defined as patients with a presentation age <6 years old without a confirmed genetic disorder, n=12), non-monogenic IBD (defined as all patients under 18 years old excluding monogenic IBD, n=212), and severe IBD (defined as patients treated with an anti-tumor necrosis factor excluding monogenic IBD, n=92). We compared demographic data, initial pediatric Crohn disease activity index/pediatric ulcerative colitis activity index (PCDAI/PUCAI) score, frequency of hospitalizations, surgical experiences, and height and weight under 3rd percentile among the patients enrolled. Results: The initial PCDAI/PUCAI score (p<0.05), incidence of surgery per year (p<0.05), and hospitalization per year (p<0.05) were higher in the monogenic IBD group than in the other IBD groups. Additionally, the proportion of children whose weight and height were less than the 3rd percentile (p<0.05 and p<0.05, respectively) was also higher in the monogenic IBD group. Conclusion: Monogenic IBD showed more severe clinical manifestations than the other groups.

Body Mass Index at Presentation of Inflammatory Bowel Disease in Children

  • Carbonell, Fernando R Medina;Chandan, Ojasvini Choyudhry
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.5
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    • pp.439-446
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    • 2020
  • Purpose: The evidence for an association between inflammatory bowel disease (IBD) and obesity is conflicting. Therefore, we set out to review the body mass index (BMI) at presentation of IBD to understand if the rise of the obesity rate in the general population, lead to an increase of obesity in patients with IBD at the time of diagnosis. Methods: Retrospective review of all patients with IBD seen at Children's Hospital and Medical Center from January 1st 2010 to December 31st 2014. From the initial visit and endoscopy, we obtained: age; sex; BMI; disease phenotype; disease severity. Results: We had a total of 95 patients, 35 patients were excluded due to incomplete data or referral being made after diagnosis was made. 28 were males and 32 were females, Age range was 2-17 years. A 37 had Crohn's disease, 19 ulcerative colitis, and 4 indeterminate colitis. Disease severity in 19 cases was mild, 29 moderate and 12 severe. BMI distribution was as follows-obese (5.0%), overweight (6.7%), normal weight (65.0%), mild malnutrition (8.3%), moderate malnutrition (15.0%), severe malnutrition (1.7%). Conclusion: Our data is consistent with other series. Showing most children had a normal BMI, regardless of disease severity or phenotypes. One confounding factor is the possibility of delay in referral to GI. This could mean some obese children may fall in the normal BMI range at the time of diagnosis due to ongoing weight loss. Future studies should include prospective cohort studies, comparing incidence of IBD in obese and non-obese patients, severity at presentation, duration of symptoms, and clinical outcomes.

The sedative effect of intranasal Midazolam additionally administered to children who fail to respond properly to oral Chloral Hydrate (Chloral hydrate 경구투여의 진정효과가 나타나지 않는 소아환자에 대한 Midazolam의 비강내 추가 투여)

  • Yoo, Byung-Kyu;Kim, Jong-Soo;Kim, Yong-Kee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.3
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    • pp.537-542
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    • 1997
  • Chloral hydrate is one of the most widely used sedative agents to control the difficult-to-treat young age group in the dental clinic. The normal onset time of oral Chloral hydrate is 30-45 minute with some variations. We are often frustrated see the patient still awake and cry with agitation even after far more than the normal onset time. In such a case, the patient has to be rescheduled for another sedation visit with different agents and/or routes which greatly disappoints the guardians. This case report presents a sedative regimen that can possibly help the clinician complete scheduled treatment without postponement. We have tried additional administration of Midazolam intranasally to 22 patients of those who failed to respond properly to the initial dose(50-75mg/kg) of oral Chloral hydrate. The average age and weight of the patients was 34.2 months(22-61 mos.) and 15.2 kg(10-17 kg) respectively. Half of the regular dose of Midazolam(0.1mg/kg) was administered intranasally. using needless syringe in 42 cases without notable resistance of the patient. The onset was very rapid in most cases and colud proceed the treatment under the constant monitoring by Pulse oximeter. All the planned procedures could be completed in 93.2 % (69.4% of 'Good' plus 23.8% of 'Fair' rating)with only 6.8 %('Poor' rating) of failure rate. Evidence of adverse effect was not detected or reported during and/or after the procedures.

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