Jung, Do Young;Kwon, Ye Rim;Yu, Min Heui;Namgoong, Mee Kyung
Childhood Kidney Diseases
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제21권2호
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pp.61-68
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2017
Purpose: To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP). Methods: A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age. Results: The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5 %), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group. Conclusion: In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome.
Background: This study was planned in an attempt to develop a scale for the quality of life in pediatric oncology patients aged 7-12, with child and parents forms. Materials and Methods: In collecting the study data, we used the Child and Parent Information Form, Visual Quality of Life Scale, Scale for Quality of Life Pediatric Oncology Patients Aged 7-12 and the Scale for the Quality of Life in Pediatric Oncology Patients Aged 7-12 for Parents. We also used Pearson correlation analysis, the Cronbach alpha coefficient, factor analysis and ROC analysis for the study data. Results: In this study, the total Cronbach alpha value of the parent form was 0.96, the total factor load being 0.54-0.90 and the total variance explained was 82.5%. The cutoff point of the parent form was 93 points. The total Cronbach alpha value for the child form was 0.96, with a total factor load of 0.55-0.91 and the total variance being explained was 78.3%. The cutoff point of the child form was 65 points. Conclusions: This study suggests that the Scale for Quality of Life in Pediatric Oncology Patients Aged 7-12 Child and Parents Forms are valid and reliable instruments in assessing the quality of life of children.
Purpose: The long-term efficacy and safety of infliximab (IFX) in children with ulcerative colitis (UC) have not been well-evaluated. Here, we reviewed the long-term durability and safety of IFX in our single center pediatric cohort with UC. Methods: This retrospective study included 20 children with UC who were administered IFX. Results: For induction, 5 mg/kg IFX was administered at weeks 0, 2, and 6, followed by every 8 weeks for maintenance. The dose and interval of IFX were adjusted depending on clinical decisions. Corticosteroid (CS)-free remission without dose escalation (DE) occurred in 30% and 25% of patients at weeks 30 and 54, respectively. Patients who achieved CS-free remission without DE at week 30 sustained long-term IFX treatment without colectomy. However, one-third of the patients discontinued IFX treatment because of a primary nonresponse, and one-third experienced secondary loss of response (sLOR). IFX durability was higher in patients administered IFX plus azathioprine for >6 months. Four of five patients with very early onset UC had a primary nonresponse. Infusion reactions (IRs) occurred in 10 patients, resulting in discontinuation of IFX in four of these patients. No severe opportunistic infections occurred, except in one patient who developed acute focal bacterial nephritis. Three patients developed psoriasis-like lesions. Conclusion: IFX is relatively safe and effective for children with UC. Clinical remission at week 30 was associated with long-term durability of colectomy-free IFX treatment. However, approximately two-thirds of the patients were unable to continue IFX therapy because of primary nonresponse, sLOR, IRs, and other side effects.
Objectives : Oriental medicine has set the no herb medicamentous dose for child, on the other hand the western medicine has it standardizing of age, weight or dimension of body. Therefore, we aimed to research the herb medicamentous dose for child being in being used in clinic. Methods : We made up a question of the oriental medical doctors of the master's and doctor's course in ○○ university. Results : 1. Child dose of herb medicine a time likes this. 1 pack is written prescription most at children patients under 1 year. 1 pack and 2 packs are written prescription most at children patients over 1 under 2. 2 packs are written prescription most at children patients over 2 under 3. 4 packs are written prescription most at children patients over 3 under 4. 10 packs are written prescription most at children patients over 8 under 14. Dose of herb medicine written prescription at children patients over 5 under 8 is in decentralization from 2 to 10 packs. 2. 2 or 3 times are most in a number of taking medicine a day. 3. 3 days are common in period of taking medicine under 5, over 10 days are common over 5. 4. It is necessary to regulating child dose of herb medicine.
Objectives : This study was conducted to evaluate the association between first episode polarity of pediatric bipolar disorder and prognosis. Methods : We analyzed the clinical records of 66 inpatient subjects with DSM-IV defined pediatric bipolar disorder. The patients were split into 2 groups according to the polarity of the illness onset [depressive onset (DO) vs. manic/hypomanic/mixed onset (MO)]. Clinical feature and prognosis were compared between the two groups of patients. Results : In our sample, 68% of patients experienced a depressive onset. In DO patients, rates of suicidal attempt, episodic illness course and comorbid disruptive behavior disorder were higher than rates in MO patients. Conclusion : Findings from this study suggest that polarity of illness onset may be useful in predicting the prognosis of pediatric bipolar disorder.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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제32권3호
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pp.93-98
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2021
Electroencephalography (EEG) measures neural activation due to various cognitive processes. EEG and event-related potentials (ERPs) are widely used in studies investigating psychopathology and neural substrates of psychiatric diseases in children and adolescents. The present study aimed to review recent ERP studies in child and adolescent psychiatry. ERPs are non-invasive methods for studying synaptic functions in the brain. ERP might be a candidate biomarker in child-adolescent psychiatry, considering its ability to reflect cognitive and behavioral functions in humans. For the EEG study of psychiatric diseases in children and adolescents, several ERP components have been used, such as mismatch negativity, P300, error-related negativity (ERN), and reward positivity (RewP). Regarding executive functions and inhibition in patients with attention-deficit/hyperactivity disorder (ADHD), P300 latency, and ERN were significantly different in patients with ADHD compared to those in the healthy population. ERN showed meaningful changes in patients with anxiety disorders, such as generalized anxiety disorder, separation anxiety disorder, and obsessive-compulsive disorder. Patients with depression showed significantly attenuated RewP compared to the healthy population, which was related to the symptoms of anhedonia.
Purpose: Golimumab (GLM) is an anti-tumor necrosis factor (TNF)-α antibody preparation known to be less immunogenic than infliximab (IFX) or adalimumab. Few reports on GLM in pediatric patients with ulcerative colitis (UC) are available. This study aimed to review the long-term durability and safety of GLM in a pediatric center. Methods: The medical records of 17 pediatric patients (eight boys and nine girls) who received GLM at the National Center for Child Health and Development were retrospectively reviewed. Results: The median age at GLM initiation was 13.9 (interquartile range 12.0-16.3) years. Fourteen patients had pancolitis, and 11 had severe disease (pediatric ulcerative colitis activity index ≥65). Ten patients were biologic-naive, and 50% achieved corticosteroid-free remission at week 54. Two patients discontinued prior anti-TNF-α agents because of adverse events during remission. Both showed responses to GLM without unfavorable events through week 54. However, the efficacy of GLM in patients who showed primary nonresponse or loss of response to IFX was limited. Four of the five patients showed non-response at week 54. Patients with severe disease had significantly lower corticosteroid-free remission rate at week 54 than those without severe disease. No severe adverse events were observed during the study period. Conclusion: GLM appears to be safe and useful for pediatric patients with UC. Patients with mild to moderate disease who responded to but had some adverse events with prior biologics may be good candidates for GLM. Its safety and low immunogenicity profile serve as favorable options for selected children with UC.
This study aims to investigate the child patients' space use and behavior with its focus on the rest and play activities. The structural observation method followed by literature review adapted to find out the commonality and difference of play activities among the age groups. Children's development and types of play activities and participation in activities were reviewed through the related studies. Preliminary research on spatial composition and facilities and the observation of child patients' play behavior and space use was carried out as a main research. A total of 148 cases were studied and PASW 18, a statistics analysis program, was used for data analysis. The results are as follows; (1) The Lobby was important space as a play and rest area. (2) The subjects mainly played physical play and social-cognitive play. The result of this study provides fundamental data for designing children's hospitals that can contribute to the treatment and health improvement of child patients.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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제27권1호
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pp.39-47
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2016
Objectives: The aim of this study was to examine the association between current suicidal or violent behavior and deficits of specific neurocognitive variables in child and adolescent inpatient samples diagnosed with mood disorder. Methods: A retrospective review of the charts of mood disorder patients hospitalized at Samsung Medical Center between April 2004 and April 2015 was conducted. Child and adolescent patients aged between 10 and 18 years old and those who finished neurocognitive function testing during their hospitalization were included. Among them patients whose full scale IQ was between 85 and 115 were selected (N=111). Participants were first divided into two age-groups-group Y ($10{\leq}age{\leq}15$, N=54) and group O ($16{\leq}age{\leq}18$, N=57)-because neurocognitive function test tools were different according to age [Wechsler Intelligence Scale for Children (WISC) for 10 to 15-year-old patients, Wechsler Adult Intelligence Scale (WAIS) for 16 to 18-year-old patients]. They were then divided according to their suicidal or violent behavior-non suicidal/violent group (NG), suicidal group (SG), violent group (VG), and both suicidal/violent group (BG). The Child Behavior Checklist (CBCL) was checked for measurement of participants' behavior and the Gordon Diagnostic System was checked for measurement of their attention efficiency. Kruskal-Wallis Test and Tukey test was used to determine the differences in neurocognitive function between groups. Results: O-SG patients showed lower scores on the comprehension subscale of WAIS-III than O-NG patients (${\chi}^2=8.454$, p=.015). O-VG patients showed lower scores on the block design subscales of WAIS than O-SG patients (${\chi}^2=7.496$, p=.024). Y-VG patients showed higher scores in aggressive behavior, externalizing problems, and total problems scores of CBCL. Conclusion: This study showed relationship between specific neurocognitive deficits and suicidal or violent behavior. These relationships were significant in relatively older adolescents.
Purpose: A change in diagnosis from ulcerative colitis (UC) to Crohn's disease (CD) has been reported in pediatric inflammatory bowel disease; however, only a few clinical characteristics and predictors of this diagnostic change have been reported. We aimed to describe the clinical characteristics of patients with UC who underwent a change in diagnosis to CD and identify variables associated with the change. Methods: The medical records of pediatric patients with UC who were followed up at the National Center for Child Health and Development between 2006 and 2019 were retrospectively reviewed. Clinical data on disease phenotype, laboratory parameters, endoscopic findings, and treatment of patients whose diagnosis changed to CD (cCD) were compared to those of patients whose diagnosis remained UC (rUC). Results: Among the 111 patients initially diagnosed with UC, 11 (9.9%) patients were subsequently diagnosed with CD during follow-up. There was no significant difference between the cCD and rUC groups in terms of sex, age at initial diagnosis, and the extent and severity of disease at initial diagnosis. Albumin and hemoglobin levels were significantly lower in the cCD group than in the rUC group. The proportion of patients who required biologics was significantly higher in the cCD group than in the rUC group (p<0.05). Conclusion: Approximately 10% children initially diagnosed with UC were subsequently diagnosed with CD. Hypoalbuminemia and anemia at initial diagnosis and use of biologics could be predictors of this diagnostic change.
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