• Title/Summary/Keyword: pediatric illness

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A Case of Gastroparesis Followed after Rotavirus Gastroenteritis (Rotavirus 위장관염 후에 발생한 위마비 1예)

  • Kim, Jae Lee;Kim, Young Hwan;Kang, Ki Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.1
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    • pp.65-69
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    • 2006
  • We experienced a 15 month old child who had persistent gastroparesis after an acute viral illness tested positive for rotavirus. She was admitted because of persistent postprandial vomiting, abdominal distension and anorexia followed after acute rotavirus gastroenteritis. Other diagnostic tests did not demonstrate any evidence of some organic disease. But, we could find the delayed gastric emptying in gastric scintigraphy. The initial percentage gastric emptying in 60 minutes tested by scintigraphy was 13.4%. The second result of percentage gastric empting after clinical improvement was 49.9%.

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MICRODONTIA IN A CHILD TREATED WITH CHEMOTHERAPEUTIC AGENT (항암 화학치료를 받은 아동의 치아발육이상 : 증례 보고)

  • Kye, Hi-Ran;Lee, Jae-Ho;Kim, Seong-Oh;Sohn, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.1
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    • pp.146-150
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    • 1999
  • With the improved cure rates for childhood malignant conditions in the past decade, late effects of cancer therapy must be recognized to minimize their impact on the quality of life in long-term survivors. Chemoradiation therapy is a major part of pediatric oncology treatment and is implicated in causing tooth agenesis, microdontia, root shortening, early apical closure, and coronal hypocalcification. Dental development may be affected by illness, trauma, chemotherapy, or radiation therapy at any point prior to complete maturation. Treatment given during the first 3.5 years of life was more likely to affect the dental lamina and crown formation and result in a small tooth. Dental treatment affected by chemoradiation damage to developing teeth includes orthodontic tooth movement, prosthetic abutment consideration, periodontal health, space maintenance, requirement for home fluoride regimens to protect hypomineralized teeth, and enodontic procedures. Dental abnormalities are common in patients treated for cancer, and these children require aggressive dental follow-up. Meticulous surveillance may facilitate detection of abnormalities, enabling the dental practitioner to intervene earlier in promoting a more aggressive regimen of oral care, thus reducing the morbidity associated with dental sequelae of oncotherapy, specifically periodontal disease and malocclusion. In this case, we report microdontia of all permanent second premolar and second molar in an 8 year old boy treated with chemotherapeutic agents during period of active dental development(14 months to 38 months of age).

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Prealbumin and Retinol Binding Proteins Are Not Usable for Nutrition Follow-Up in Pediatric Intensive Care Units

  • Tekguc, Hakan;ozel, Deniz;Sanaldi, Huriye;Akbas, Halide;Dursun, Oguz
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.321-328
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    • 2018
  • Purpose: Feeding children is a problem in pediatric intensive care units (PICU) and it is difficult to know the correct amount. The purpose of this study is to evaluate if prealbumin or retinol binding proteins (RBP) are effective relative to daily enteral nutrition, without being affected by severity of diseases or infections and can be used to follow up nutritional amount. Methods: This is a prospective observational study that includes 81 patients admitted to PICU in Akdeniz University with estimated duration >72 hours, age between 1 month and 8 years. Daily calorie and protein intake were calculated and prealbumin, RBP and C-reactive protein (CRP) levels were measured on the first, third, fifth and seventh mornings. Results: We find moderate correlation between daily calorie intake and prealbumin levels (r=0.432, p<0.001), RBP levels and daily protein intake (r=0.330, p<0.001). When we investigated the relationship between changes of prealbumin, RBP, CRP, calorie and protein intake during intensive care stay, we found that increase of Prealbumin and RBP levels are explained by decrease of CRP levels (r=-0.546 and -0.645, p<0.001) and not with increase of nourishment. Conclusion: Even adjusted for PRISM3, age and CRP, prealbumin and RBP are correlated with last 24 hours' diet. However, it is not convenient to use as a follow up biomarker because increase of their levels is related with decrease of CRP levels.

Comparison of clinical features and laboratory findings of coronavirus disease 2019 and influenza A and B infections in children: a single-center study

  • Siddiqui, Meraj;Gultekingil, Ayse;Bakirci, Oguz;Uslu, Nihal;Baskin, Esra
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.364-369
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    • 2021
  • Background: As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is crucially important for pediatricians to be aware of the differences in demographic and clinical features between COVID-19 and influenza A and B infections. Purpose: This study analyzed and compared the clinical features and laboratory findings of COVID-19 and influenza A and B infections in children. Methods: This retrospective study evaluated the medical data of 206 pediatric COVID-19 and 411 pediatric seasonal influenza A or B patients. Results: COVID-19 patients were older than seasonal influenza patients (median [interquartile range], 7.75 [2-14] years vs. 4 [2-6] years). The frequency of fever and cough in COVID-19 patients was lower than that of seasonal influenza patients (80.6% vs. 94.4%, P<0.001 and 22.8 % vs. 71.5%, P<0.001, respectively). Ageusia (4.9%) and anosmia (3.4%) were present in only COVID-19 patients. Leukopenia, lymphopenia, and thrombocytopenia were encountered more frequently in influenza patients than in COVID-19 patients (22.1% vs. 8.5%, P=0.029; 17.6% vs. 5.6%, P=0.013; and 13.2% vs. 5.6%, P=0.048, respectively). Both groups showed significantly elevated monocyte levels in the complete blood count (70.4% vs. 69.9%, P=0.511). Major chest x-ray findings in COVID-19 patients included mild diffuse ground-glass opacity and right lower lobe infiltrates. There were no statistically significant intergroup differences in hospitalization or mortality rates; however, the intensive care unit admission rate was higher among COVID-19 patients (2.4% vs. 0.5%, P=0.045). Conclusion: In this study, pediatric COVID-19 patients showed a wide range of clinical presentations ranging from asymptomatic/mild to severe illness. We found no intergroup differences in hospitalization rates, oxygen requirements, or hospital length of stay; however, the intensive care unit admission rate was higher among COVID-19 patients.

The Clinical Study for Empyema: 176 Cases (농흉의 임상적 고찰[176예])

  • Oh, Bong-Seok;Choi, Jong-Beom;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.13 no.4
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    • pp.475-485
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    • 1980
  • For the past 5 year 6 months from January 1975 to June 1980, 176 patients with empyema have been treated in Chonnam University Hospital. They were 134 males and 42 females ranging from ] 8 days to 69 years of age. [mean age: 26.1 years] The duration of illness prior to treatment was relatively shorter in pediatric group than in adult group, that is, the duration of less than 1 month was 89.5% in pediatric group and 38.0% in adult group. In bacteria study there were Staphylococcus 26.1%, Streptococcus 17.6%, E. coil 10.8%, Pseudomonas 10.8%, Diplococcus pneumoniae 5.7% and Candidia. And 4 children and 3 adults had infections of two species of bacteria. The underlying pathologic lesions were pyogenic pneumonia 34.7%, tuberculosis 29.5%, paragonimiasis 15.3%, trauma 9.7% and postoperative state. The over-all mortality rate was 1.7% [3 patients]. The causes of death were sepsis In 1 child and sepsis secondary to esophageal fistula in 2 adults. Adequate drainage and obliteration of the pleural space seems to be the most important aspect of treatment and can frequently be achieved by initial tube drainage in acute empyema, especially in the pediatric group. The chronic thick walled or loculated cavities required open window therapy, decortication, resection therapy and sterilization. Modified Eloesser`s operation and 0.3-0.5% potadine irrigation brought good result in the patients who had general weakness, marked pulmonary parenchymal destruction due to pyothorax, and pyothorax with severe bronchopleural fistula.

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Evaluating the Validity of the Pediatric Index of Mortality Ⅱ in the Intensive Care Units (소아중환자를 대상으로 한 PIM Ⅱ의 타당도 평가)

  • Kim, Jung-Soon;Boo, Sun-Joo
    • Journal of Korean Academy of Nursing
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    • v.35 no.1
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    • pp.47-55
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    • 2005
  • Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919~0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

A Case of Subacute Necrotizing Lymphadenitis Associated with Yersinia Infection in a 12 Years Old Child (소아에서 발생한 Yersinia pseudotuberculosis 감염이 동반된 아급성 괴사성 림프절염 1례)

  • Sim, Yoon-Hee;Lim, In Seok;Lee, Dong Keun
    • Pediatric Infection and Vaccine
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    • v.10 no.1
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    • pp.123-126
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    • 2003
  • Kikuchi disease(subacute necrotizing lymphadenitis), first reported by Kikuchi and Fujimoto in 1972, is a benign self-limiting illness characterized by fever, neutropenia and cervical lymphadenopathy and develops predominantly in young women, especially in Asia. The cause of Kikuchi disease is unknown, but postinfectious(virus or bacteria) hyperimmune reaction has been suggested. Few pediatric cases have been reported. We experienced a case of Kikuchi disease associated with Yersinia pseudotuberculosis infection in 12-year-old girl. After she was admitted with cervical lymphadenopathy and headache, followed by sustained fever with leukopenia. All symptoms and signs did not seem to be responded to antimicobial treatment. Open biopsy of cervical lymph node was performed and showed findings consistent with subacute necrotizing lymphadenitis. Serologic studies were all negative except for Y. pseudotuberculosis. Fever subsided and lymphadenopathy improved after administration of oral steroid for 1 week.

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Analysis of Clinical Factors and Operative Findings in Childhood Intussusception (소아 장중첩증에서 임상양상과 수술소견과의 관계에 관한 분석)

  • Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.81-87
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    • 1996
  • Although nonoperative reduction plays a major role in the management of uncomplicated intussusception in the pediatric age group, surgical treatment is still a necessary alternative when nonoperative reduction is unsuccessful. The author analyzed the clinical features of 68 patients requiring operation in order to identify factors which might influence the type of operative management. A nine-year experience at Ewha Womans University Hospital was reviewed, and the findings compared to previous reports. Barium was used for the initial reduction attempt in 33 cases, saline in 35. Manual reduction by milking at operation achieved success in 41 cases(60.3%). Fifteen cases(22.1%) required resection of bowel, and 12 patients(17.6%) were found to have spontaneous and complete reduction of the intussusception at operation. Two cases had pathologic leading points. There were no perforations due to nonoperative reduction. There were no significant differences in demographic data, clinical findings, laboratory data, and anatomic type of intussusception between barium and saline reduction groups. However, a significant number of cases with spontaneous reduction were in saline reduction group(p<0.05). There was a slight chance of spontaneous reduction in infants under 6 month of age(p<0.001). Age under 6 month. body temperature over $38^{\circ}C$, symptom over 24 hours, and ileo-colic and ileo-ileo-colic intussusception contributed significantly to the necessity for bowel resection(p<0.05-0.001). The author believes that the age, body temperature, duration of illness, and anatomic type of intussusception strongly influence operative management.

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Therapeutics in the Treatment of COVID-19 for Children and Adolescents (소아청소년 코로나바이러스감염증-19의 치료: 치료 약제를 중심으로)

  • Choi, Soo-Han;Choi, Jae Hong;Yun, Ki Wook
    • Pediatric Infection and Vaccine
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    • v.29 no.1
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    • pp.1-15
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    • 2022
  • Coronavirus disease 2019 (COVID-19) presents as a mild-to-moderate respiratory illness in most children. However, a small proportion of children with COVID-19 develop severe or critical illnesses. Although pediatric clinical trials for the treatment of COVID-19 are sparse, some drugs are available for children and adolescents with severe COVID-19. This review summarizes clinical data focusing on antiviral agents and immunomodulators for use in treating COVID-19. In addition, current recommendations for therapeutics for children and adolescents with COVID-19 are discussed.

A Case of Erythema Nodosum Associated with Mycoplasma pneumoniae Infection: Pathologic Findings and a Presumed Pathogenesis (마이코플라즈마 폐렴균 감염에 의한 결절성 홍반; 조직병리학적 소견과 병인론의 고찰)

  • Ju, Hee Young;Kim, Gou Young;Choi, Sun Hee
    • Pediatric Infection and Vaccine
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    • v.23 no.1
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    • pp.67-71
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    • 2016
  • Erythema nodosum (EN) is a painful skin disease characterized by erythematous tender nodules located predominantly over the extensor aspects of the legs. Various etiological factors, including infection, drug administration, and systemic illness have been implicated as causes of EN. Mycoplasma pneumoniae is one of rare infectious agents to cause EN in children. We report a case of a 7-year-old boy with context of respiratory illness and skin lesions with arthralgia. From stepwise approaches, IgM antibody against M. pneumoniae was positive with titers of 12.18, consistent with respiratory infection of M. pneumoniae and histopathology showed findings of septal and lobular inflammation without vasculitis consistent with EN. In addition, we reviewed the pathogenesis of this disease based on our case and the previous reports.