• Title/Summary/Keyword: Pediatric intervention

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Two adolescent cases of Fitz-Hugh-Curtis syndrome (청소년에서의 Fitz-Hugh-Curtis Syndrome 2례)

  • Kim, Ji Hye;Oh, Sung Hee
    • Clinical and Experimental Pediatrics
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    • v.52 no.9
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    • pp.1038-1043
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    • 2009
  • Two adolescent cases of Fitz-Hugh-Curtis syndrome, which has not been previously reported in Korean girls, presenting with right upper-quadrant abdominal pain, nausea, vomiting, and fever are reported here. A careful and thorough inquiry into the sexual history of the first patient, which was not done upon admission, led to a careful reassessment of the dynamic abdominal computed tomography scan revealing hepatic capsular enhancement without evidence of gallbladder or liver disease. Both cases were diagnosed noninvasively and were treated successfully by medical intervention. A high index of suspicion of Fitz-Hugh-Curtis syndrome should be implemented in the differential diagnosis of right upper quadrant pain, particularly in sexually active girls, for a prompt diagnosis and rapid cure.

Diagnosis of inherited metabolic disorders based on their diverse clinical features and laboratory tests (유전성 대사질환의 임상증상과 진단)

  • Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1140-1151
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    • 2006
  • Inherited metabolic disorders are individually rare but as a whole, they are nor rare. Since Archibald Garrod introduced a concept of "inborn error of metabolism" or "chemical individuality", more than 500 diseases are currently known, affecting approximately one in 500 newborns cumulatively. They frequently manifest with acute, life-threatening crisis that require immediate specific intervention or they present with insidious diverse symptoms and signs involving multiple visceral organs or tissues as well as central nervous system, hampering a correct diagnosis. In addition, many pediatricians are not familiar with all diagnostic and therapeutic strategies for diverse inherited metabolic disorders. However, the prognosis of affected children are heavily dependent on rapid and effective treatment. In this lecture, practical guidelines for the specific diagnosis based on diverse clinical features of inherited metabolic disorders will be described. Many sophisticated laboratory tests are available for confirmatory diagnosis of each disease, which challenge to general pediatricians with respect to knowledge about biochemical metabolite assay test, enzymatic test and DNA diagnostic tests. Sample collections, indications, methods and interpretation of results in varying laboratory tests will be listed as well.

Nutritional approach to failure to thrive

  • Jeong, Su-Jin
    • Clinical and Experimental Pediatrics
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    • v.54 no.7
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    • pp.277-281
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    • 2011
  • Failure to thrive (FTT) is a term generally used to describe an infant or child whose current weight or rate of weight gains is significantly below that expected of similar children of the same age, sex and ethnicity. It usually describes infants in whom linear growth and head circumference are either not affected, or are affected to a lesser degree than weight. FTT is a common problem, usually recognized within the first 1-2 years of life, but may present at any time in childhood. Most cases of failure to thrive involve inadequate caloric intake caused by behavioral or psychosocial issues. The most important part of the outpatient evaluation is obtaining an accurate account of a child's eating habits and caloric intake. Routine laboratory testing rarely identifies a cause and is not generally recommended. FTT, its evaluation, and its therapeutic interventions are best approached by a multi-disciplinary team includes a nutritionist, a physical therapist, a psychologist and a gastroenterologist. Long term sequelae involving all areas of growth, behavior and development may be seen in children suffering from FTT. Early detection and early intervention by a multidisciplinary team will minimize its long term disadvantage. Appropriate nutritional counseling and anticipatory guidance at each well child visit may help prevent some cause of FTT.

Knowledge, Experience and Self-efficacy regarding Children's Pain Management among Nursing Students (아동 통증관리에 대한 간호대학생의 지식, 경험 및 자기효능감)

  • Ha, Young-Ok;An, Ji-Yoen
    • Korean Parent-Child Health Journal
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    • v.18 no.1
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    • pp.1-10
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    • 2015
  • Purpose: This study was to investigate nursing students' knowledge, experience and self-efficacy regarding children's pain management. Methods: A descriptive research design was used. The participants in this study were 167 senior nursing students who understood purpose of this study and accepted to participate in. The Pediatric Nurses' Knowledge and Attitude Survey regarding Pain (PNKAS) was used to measure knowledge toward children's pain management. Data were collected from December 15 to December 30, 2012. Results: The overall percentage of correct answer was 56%. The pain assessment scale and non-pharmacological pain intervention which senior nursing students used in most were face pain rating scale (94.6%, n=158/167) and emotional support (93.4%, n=156/167). Significant differences were found in self-efficacy scores between above-average group of knowledge score. Conclusion: This study showed that undergraduate nursing students had a lack of knowledge for children's pain management. There is a need for more detailed educational program in the area of children's pain management.

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A Case of Non-traumatic Rhabdomyolysis after Doxylamine Overdose (Doxylamine 중독 후 합병한 비 외상성 횡문근융해증 1례)

  • Hwang, Sung Woog;No, Hyeung Kyeung;Kim, Kee Hyuck
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1033-1037
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    • 2002
  • Doxylamine is an antihistamine of the ethanolamine class. It is used primarily as a sleep-inducing agent. Clinicians should be aware of the complications in rhabdomyolysis patients who ingest doxylamine succinate and over-the-counter antihistamines. The easy availability of these substances increases the potential not only of intentional overdose by adults but also of inadvertent ingestion by children. Prompt intervention and careful assessment of renal function, urinary output, and serum creatine kinase levels may represent the difference between an uncomplicated and acute renal failure. Recognition of the potential for rhabdomyolysis and institution of vigorous treatment may prevent acute renal failure in patients who have taken an overdose of the drug. A 14-year-old male was found to have hematuria and oliguria. Evaluation of the patient revealed myoglobinuria, and a creatine kinase(CK) level of 117,563 IU/L. He was recovered by massive fluid administration, urine alkalization and mannitol infusion. We report a case of a suicide attempt in a child where ingestion of the doxylamine complicated by non-traumatic rhabdomyolysis with brief review related literatures.

Relationship between Job Stress and Compassion Satisfaction, Compassion Fatigue, Burnout for Nurses in Children's Hospital (어린이병원 간호사의 업무 스트레스와 공감만족, 공감피로, 소진 간의 관계)

  • Choi, Heekang;Park, Jisun;Park, Mijeong;Park, Bobae;Kim, Yeseul
    • Child Health Nursing Research
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    • v.23 no.4
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    • pp.459-469
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    • 2017
  • Purpose: Nurses experience burnout related to various factors. For this descriptive research job stress, compassion satisfaction, and compassion fatigue were examined as to their relationship to burnout in nurses from children's hospital. Methods: The participants were 305 nurses working in children's hospital. Self-report questionnaires were used to measure job stress, compassion satisfaction, compassion fatigue and burnout. Results: Nurses in children's hospital experienced a greater than moderate degree of job stress, compassion satisfaction, compassion fatigue and burnout, whereas differences existed according to general characteristics. Job stress, compassion fatigue and burnout showed a significant positive correlation and results of compassion fatigue and burnout were similar. Also, job stress, compassion satisfaction and compassion fatigue were associated with burnout in nurses working in children's hospital. Conclusion: Findings indicate that as longer work experience is accompanied by higher job stress and burnout, it is necessary to develop intervention programs to reduce burnout among career nurses exposed to greater job stress in children's hospital.

Two Case of Pulmonary Arteriovenous Fistula Treatment Depending on the Presence of Pulmonary Hypertension (폐동맥고혈압 동반여부에 따른 폐동정맥루의 치료)

  • Huh, Yun Jeong;Kim, Jeong Tae;Choi, Jae Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.216-220
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    • 2005
  • Pulmonary arteriovenous fistulas(PAVFs) is a rare disorder that occurs in two to three children per 100,000 population. It is presented as absence of intervening capillary beds between the pulmonary artery and vein with resultant persistent right to left shunt. Other causes include trauma, liver cirrhosis, malignancy and schistosomiasis. It is mostly asymptomatic, but it may present with respiratory difficulty, cyanosis, clubbed fingers induced by right to left shunt or hemoptysis, polycythemia and epistaxis. Major complications, such as brain abscess, brain embolism, paradoxical embolism and subacute infective endocarditis can be devastating, so therapeutic intervention is recommended in all patients. However, removal of low-resistance fistulas can aggrevate pulmonary hypertension, so detection of increased pulmonary pressure is important. We report two patients : One a 42 year-old male with PAVFs treated with coil embolization, and a 42 year-old female who was treated with anticoagulants due to pulmonary hypertension.

School Urine Screening Program in Korea (우리나라의 학교소변검사 프로그램)

  • Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.57-63
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    • 2014
  • A number of kidney diseases of childhood may present as isolated proteinuria or/and hematuria, without any overt signs or symptoms. Urinalysis is a simple and inexpensive test used to evaluate various renal disorders. A school urine screening (SUS) program for kidney disease was conducted in Korea in 1998. Several research reports, including case reports and systemic reviews of SUS data, claimed that early detection and confirmatory diagnosis by renal biopsy seems to be helpful for determining the prognosis and intervention of progressive chronic renal disease. However, there is no global consensus as to whether screening for chronic kidney disease (CKD) should be undertaken in children and adolescents. This paper reviews the SUS for CKD in Korea, including the history and structure of the program, its assessment, related research, and associated problems.

A Case of the Diarrhea-associated Hemolytic Uremic Syndrome Developing Simultaneously with an Acute Appendicitis (급성충수염과 동시에 발생한 설사 연관형 용혈성 요독 증후군 1례)

  • Oh Ji-Eun;Chang Ji-Yeon;Jung Kyeong-Hun;Kim Soon-Ki;Hong Young-Jin;Son Byong-Kwan;Lee Ji-Eun
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.77-81
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    • 2003
  • Diarrhea-associated hemolytic uremic syndrome is rarely accompanied by complications requiring surgical intervention. We report a case of the diarrhea-associated hemolytic uremic sydrome which developed simultaneously with an acute appendicitis.

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Pseudo-Aneurysm in Internal Maxillary Artery Caused by Radiofrequency Ablation: Literature Review with a Case Report

  • Yang, Hyun-Woo;Oh, Ji-Hyun;Nam, Ok-Hyung;Lee, Chunui
    • Journal of Oral Medicine and Pain
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    • v.45 no.2
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    • pp.44-47
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    • 2020
  • The case of pseudo-aneurysm of internal maxillary artery (IMA) in oral and maxillofacial region is known to be very rare. The etiology of this case was regarded as IMA injury by radiofrequency ablation (RFA) and such incidence was not reported previously. One case of false aneurysm in the IMA was referred from local dental clinic to our department. Left facial swelling was observed with severe trismus immediately after radiofrequency procedure for masseteric nerve block in local dental clinic. Despite of medication and surgical intervention, the swelling did not subside and there was massive bleeding and pulsation on one of the follow ups. The traumatic vascular disorder was suspected and finally diagnosed with angiography and treated by embolization procedure. RFA targeting masseteric nerve or trigeminal ganglion may cause traumatic injury to adjacent anatomic structures such as IMA, resulting in pseudo-aneurysm. Clinicians must be aware of potential damages of RFA. Angiography enables the solid diagnosis for pseudo-aneurysm, and selective embolization can be optimum treatment method.