• Title/Summary/Keyword: pediatric illness

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An Exploratory Study of Nursing Problems in Adolescents with Nephrotic Syndrome (신증후군 청소년의 간호문제에 관한 탐색적 연구)

  • 강창희
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.604-619
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    • 1992
  • This study was designed to investigate the problems facecl by adolescents who have nephrotic syndrome and who have struggled with their disease over a long time. Information obtained from this study can be utilized as basic data in planning nursing care for these adolescents. The subjects in this study were 13 adolescents who were being treated in the pediatric OPD of one general hospital in Seoul. The treatment period ranged from 2 to 15 years. The tool for this study was constructed after asking patients with nephrotic syndrome about their problems using anunstructured questionalire. Problem items which were observed during nursing cared in the pediatric unit. were also inclucled. Ten problem items were constructed on the basis of Moonlcy's problem check list and two additional items related to diet and physical activity were added to the list. The results of this study can be summerized as follows : adolescents with Nephrotic Syndrome. 1) have a vague knowledge about their illness and have distorted concepts. 2) feel social isolation within their peer group because of their changed appearance, limited physical activity and special diet regimen. 3) have problesm in heterosexual relationship because of short height in boys and changes in body propotions in girls. 4) think that their personality has changed due to illness. In most cases(8) changes were in a negative direct ion but in two cases they were positive. 5) have problems with scholastic achievement due to physical weakness and school absence. 6) who are in late adolescentce are more realistic and plan for their future taking into consideration their prognosis much more so than do patients who are in early adolescence. 7) have problems in their peer relationships. 8) have limitation their enjoy ment of leisure time. 9) have some conflict with their siblings. 10) think religion is significant and it has and influence on their life.

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A young child of anti-NMDA receptor encephalitis presenting with epilepsia partialis continua: the first pediatric case in Korea

  • Kim, Eun-Hee;Kim, Yeo Jin;Ko, Tae-Sung;Yum, Mi-Sun;Lee, Jun Hwa
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.133-138
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    • 2016
  • Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness. The seizures evolved into epilepsia partialis continua and were accompanied by epileptiform discharges from the left frontal area. Three weeks after admission, the patient's seizures were reduced with antiepileptic drugs; however, she developed sleep disturbances, cognitive decline, noticeable oro-lingual-facial dyskinesia, and choreoathetoid movements. Anti-NMDAR encephalitis was confirmed by positive detection of NMDAR antibodies in the patient's serum and cerebrospinal fluid, and her condition slowly improved with immunoglobulin, methylprednisolone, and rituximab. At present, the patient is no longer taking multiple antiepileptic or antihypertensive drugs. Moreover, the patient showed gradual improvement of motor and cognitive function. This case serves as an example that a diagnosis of anti-NMDAR encephalitis should be considered when children with uncontrolled seizures develop dyskinesias without evidence of malignant tumor. In these cases, aggressive immunotherapies are needed to improve the outcome of anti-NMDAR encephalitis.

Relation of Sampling Time to the Detection of Enteroviral RNA in Cerebrospinal Fluid from the Patients with Aseptic Meningitis (무균성 수막염 환자의 뇌척수액 채취 시기와 장바이러스 RNA 검출과의 관계)

  • Lee, Kyu Man;Park, Soon Young;Kang, Hee Jung;Lee, Eun Hee
    • Pediatric Infection and Vaccine
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    • v.3 no.2
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    • pp.163-167
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    • 1996
  • Aseptic meningitis, the most common infection of the central nervous system, is an acute illness mostly caused by enteroviruses. Cerebrospinal fluid(CSF) has been used for the detection of enteroviral RNA but the detection has been mostly performed in a single CSF specimen obtained during the illness. A major objective was to evaluate the relation of sampling time to the recovery of enteroviral RNA in CSF. Thirty seven CSF specimens were obtained from 24 patients between May and August 1993, when an outbreak of asceptic meningitis by echovirus type 9 occurred. Enteroviral RNA in CSF was detected by polymerase chain reaction(PCR). Data about onset of symptom development were obtained by review of medical records. Enteroviral RNA was detected by PCR in 29 of 37 CSF specimens. PCR yielded positive results in 4 of 5 CSF specimens obtained on day 1 to 3, 10 of 11 on day 4 to 6, 8 of 10 on day 7 to 9, 6 of 8 on day 10 to 12, 1 of 3 on day 13 to 15 postonset. Of 11 patients from each of whom more than one CSF were obtained on different day postonset, PCR yielded positive resutls in 2 of 3 cases in whom enteroviral RNA detection was negative in the first CSF. These results indicate that two or more CSF specimens obtained within 12 days postonset are required for improving the accuracy of the diagnosis of enteroviral meningitis.

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A Clinical study on Pediatric Bronchial Asthma (소아천식에 대한 임상적 고찰)

  • Kim, Yun-Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.16 no.1
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    • pp.133-148
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    • 2002
  • Objective : This study was to investigate more effective oriental medical treatment for Pediatric Bronchial Asthma Method : Aroma therapy and Herbal medicine was given to 28 pediatric bronchial asthma patients(19 males and 9 females) for about 5months from the First, August 1999 The Fifth, January 2002. Results: 1. Demographic factor : The sample consisted of 28 persons among whom 19 were male, 9 were female. The age ranges from 1 year old to 6 year old. Less than 2 year old were 4 and 2-6 year old were 20. 2.Residence : Apartment and villar dwellers were 19(67.9%), Residential street divellers were 9(32.1%). 3.Age distribution at on set : 6(21.4%) fell ill befor 1 year old and 22(78.6%) fell ill after 1 year old 4. The period of illness : 9(32.2%) suffered during 1-3 year and 6(21.4%) suffered during 6 mouth-1year and 6(21.4%) suffered during more than 3 year. 5. Frequency of the symptoms : The symptoms appeared 2-3 times a year in the case of 16(57.2%), one time a year in the case of 1, 4 times a year in the case of 6(21.4%). 6. Concomitance symptoms : All experienced coughing sign, wheezing, 23(82.1%) experienced epistaxis, nose dripping, 13(46.4%) got fever, anorexia. 7. Past history of illness : 16(57.1%) got brochiolitis, brochitis, 12(42.9%) suffered pneumonia, 9(32.1%) had allergic rhinitis. 2 had allergic rhinitis, sinusitis, atopic dermatitis, bronchial asthma, 3 got atopic dermatitis, bronchial asthma and 7 had allergic rhinitis, sinusitis, bronchial asthma, 8. Family disease : In the case of family disease, 21(75%) had allergic dermatitis, 9(42.9%) had bronchial asthma, 8(38.1%) had allergic dermatitis. 9. The symptoms became very severe in the change of season in the case of 13(46.4%) and in the case of 11(39.3%), the change of season made no difference 10. Associated caused of induction symtoms : 28(100%) got sick by common cold, infectional disease, 8(28.6%) got sick by cold food, cold air 11.The kind of therapy : 15(53.6%) got oriental therapy after occidental therapy, 11(39.3%) took only oriental therapy. 12. Improvement degree of each symptoms : In the case of cough and wheeze that are the main symptoms of bronchial asthma, 78.6% and 64.3% of the patients replied < improvement > and in the case of dyspnea, tachypnea 41.7% of the patients replied . In other symptoms, all replied 13. Degree of satisfaction : 19(67.9%) replied , 2(7.1%) replied . Conclusion : Herbal medicine and aroma therapy proved to be a very effective oriental medical treatment for pediatric bronchial asthma.

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A Study on the Status of Utilization and Criteria for Selection of Medical Care Facilities of Elementary School Children (초등학생들의 의료기관 이용양상 및 선택 기준에 관한 연구)

  • Han, Seung Pyo;Kim, Eun Young;Rho, Young Il;Yang, Eun Seok;Park, Sang Kee;Park, Yeong Bong;Moon, Kyung Rye
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.166-173
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    • 2002
  • Purpose : The aim of this study is to find out the distribution of illness, patterns of medical care utilization and factors determining medical care utilization in elementary school children. Methods : We performed the questionnaires in Gwangju city on 2,036 children of two elementary schools from June 1 to June 30, 1998. Results : The prevalence rate of illness was 32.3%. The distribution of illness was respiratory disease(64.7%), gastrointestinal disease(12.8%), injury & poisoning. The rate of persons having received medical treatment when they were sick, was 89.8%. The selection distribution among various medical facilities was pediatric hospital(46.7%), otolaryngologic hospital(19.8%), pharmacy (13.2%) and internal medicine in the decreasing frequency sequence. The major factors influencing the selection of medical facility were geographic accessibility and good results. The most common reason for the first visit to the pediatric hospital was geographic accessibility. The most common reason for a visit and to otolaryngologic hospital was a good result. The most frequently utilized medical facility for respiratory symptoms and gastrointestinal symptoms was pediatric hospital. The persons influencing the selection of medical facility in the children were mother(73.3%), father( 10.8%), doctor and others in decreasing sequence. The persons answering the questionaire thought that the optimal age of pediatric care was from 0 to 12 years(47.8%), to 10 years(22.4%) and to 15 years(18.5%) in decreasing rate. Conclusion : Other departments instead of pediatrics have treated children. Children have particular growth and development process, which is different to those of adults. So, it is necessary to choose special medical care and adequate medical facilities for children.

A Pediatric Case of Dengue Fever with Extreme Hyperglycemia Developed in a Family Who Returned from India (인도에서 귀국한 가족에서 발생한 심한 고혈당 동반 소아 뎅기열 1례)

  • Kim, Joon Young;Kim, Han Wool
    • Pediatric Infection and Vaccine
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    • v.27 no.2
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    • pp.140-146
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    • 2020
  • Dengue fever (DF) is endemic throughout tropical and subtropical regions; however, it is not endemic in Korea. Imported infectious diseases should be suspected when encountering returned travelers with non-specific symptoms such as fever, rash, and headache. Persistent vomiting, abdominal pain, hemorrhagic tendency, hepatic enzyme abnormalities, and proteinuria are risk factors for the development of severe DF in a patient with DF. Severe hyperglycemia is also known to be related to poor prognosis in acute illness, and with certain underlying diseases that present with hyperglycemia, such as diabetes, it is related to the progression of severe DF. We report a DF case with severe hyperglycemia in an adolescent returning from India. Pediatric DF cases reported in Korea were also reviewed.

The Impact of Chronic Illness on Children and their Families (아동의 만성질환이 환아 및 환아 가족의 일상생활에 미치는 영향)

  • Han, Kyung-Ja;Park, Yeun-Hwan
    • Journal of Home Health Care Nursing
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    • v.8 no.2
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    • pp.135-147
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    • 2001
  • The aim of this descriptive study was to identify the impact of chronic illness on children and their families. Mothers of 177 children with chronic disease were recruited from aged one to 17 years hospitalizing the pediatric nursing unit at one university hospital. 28 questions. a self-complete maternal questionnaire developed by researchers based on literatures and 'The Impact of Childhood Illness Scale' (Hoare & Russell, 1995) assess four aspects of the child's and family's lifestyle with two dimensions for each question. the frequency of the problem and its importance of concern that it cause. In the data analysis. Pearson correlation coefficients and analysis of variance were used to test any association and a statistical comparisons. between individual variables and the impact on child's and family's lifestyle. The results were as follows: 1) There were the higher mean scores on the importance dimension than on the frequency dimension on total impact on child's and family's lifestyle. On the importance dimension. mothers had much higher levels of concern about impact on child's development and adjustment among subscales. On the frequency dimension, mothers had much higher levels of concern about impact on the family daily living on subscales. 2) The impact on child's and family's lifestyle related on individual variables were: (1) On the importance dimension. there was statistically significant low in the impact on child's development and adjustment among subscales in older parent group compared with it of younger parent group. (2) On the frequency dimension. there were statistically significant high in the impact on child's development and adjustment among subscales in the children with leukemia or cancer compared with it of the other children who had another chronic illnesses. And there were statistically significant high in the impact on child's development and adjustment among subscales in less than high school educated mothers compared with it of mothers who was educated college level. (3) On the frequency dimension. There were statistically significant high in the impact on family's daily living among subscales and total impact on child's and family's lifestyle in female children. (4) There was positive correlation between impact on parents daily living and frequency of child's hospitalization on the frequency dimension. but there was negative correlation between the two variables on the importance dimension. (5) There was positive correlation between impact of chronic illness and its treatment and duration of child's hospitalization on the frequency dimension. In conclusion. these results were reflected by the high level of concerns about impact on child's development and adjustment although mothers had frequently responded about the impact on the family daily living. We suggest consistent intervening program that help the family empowering to make children live with and adjust to their chronic illnesses from the point of diagnosis and after discharge from the hospital. We also suggest these results can be utilized as a useful data in the practice of home health nursing for children who have chronic illnesses and their families.

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The Efficacy of Rapid Antigen Tests for Detection of Seasonal Influenza Virus (계절 인플루엔자 진단에서 신속항원검사의 유용성)

  • Lee, Jun Yeol;Lee, Sol;Kim, Han Sung;Kim, Kwang Nam
    • Pediatric Infection and Vaccine
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    • v.24 no.1
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    • pp.31-36
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    • 2017
  • Purpose: This study aimed to examine the accuracy of rapid influenza diagnostic tests (RIDT) in children with an influenza-like illness and to evaluate factors associated with greater accuracy. Methods: Pediatric patients, who visited Hallym University Sacred Heart Hospital with an influenza-like illness between June 2011 and May 2016, were enrolled in this study. We tested 798 samples using a real-time polymerase chain reaction (PCR) for respiratory viruses and compared the results with rapid influenza tests. Results: In comparison with the results of the multiplex PCR, the positive agreement rates of RIDT for influenza A and B virus were 75.7% and 60.0%, respectively. The performance of RIDT varied according to days after fever onset. The positive agreement rates of RIDT for influenza A and B tests, performed within 4 days of fever onset, were 77.6% and 73.2%, but the rates for tests performed more than 5 days after fever onset were 66.7% and 21.4%, respectively. Conclusions: The RIDT is a quick and simple aid to diagnosis, but is less sensitive than the labeled sensitivity. Moreover, test performance varied according to days after fever onset. Test specimens for RIDT should be collected as soon as possible after the onset of symptoms (less than 4 days).

Urosodeoxycholic Acid Therapy in a Child with Trimethoprim- Sulfamethoxazole-induced Vanishing Bile Duct Syndrome

  • Cho, Hyun Jeong;Jwa, Hye Jeong;Kim, Kyu Seon;Gang, Dae Yong;Kim, Jae Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.4
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    • pp.273-278
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    • 2013
  • We present a case of a 7-year-old boy who had cholestasis after trimethoprim-sulfamethoxazole combination therapy. Liver biopsy was performed 36 days after the onset of jaundice because of no evidence of improving cholestasis. Liver histology revealed portal inflammation, bile plug, and biliary stasis around the central vein with the loss of the interlobular bile ducts. Immunohistochemical stains for cytokeratin 7 and 19 were negative. These findings were consistent with those of vanishing bile duct syndrome (VBDS). Chlestasis was progressively improved with dose increment of urosodeoxycholic acid from conventional to high dose. This is the first case report of trimethoprime-sulfamethoxazole associated VBDS in Korean children. The case suggests that differential diagnosis of VBDS should be considered in case of progressive cholestatic hepatitis with elevation of alkaline phosphatase and gamma-glutamyl transpeptidase after or during taking medicine to treat nonhepatobiliary diseases illness.

A Case of Thickened Gallbladder Wall and Pneumonia in a Child with Infectious Mononucleosis (담낭염과 폐렴을 동반한 전염성 단핵구증 1례)

  • Kim, Hyun Soo;Kim, Hyung Suk;Shin, Young Kyoo;Eun, Baik Lin;Park, Sang Hee;Cha, Sang Hoon
    • Pediatric Infection and Vaccine
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    • v.4 no.1
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    • pp.167-173
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    • 1997
  • Acute infectious mononucleosis, caused by Epstein-Barr virus(EBV), is a self limited lymphoproliferative illness that is common in adolescents and young adults. It shows many complications in multiple organ systems, but the hepatobiliary and the respiratory complication is uncommon. We report a case with thickened gallbladder wall and pneumonia as complications of acute infectious mononucleosis in a child. Also the related literature were reviewed. A 4 year old boy presented with a history of high fever, cough, and abdominal distension for 20days. Physical Examination revealed audible crackles in whole lung field and gross hepatomegaly. Chest X-ray showed pneumonia and liver function tests were abnormal. Ultrasonography and computed tomography revealed a thickened gallbladder wall and hepatosplenomegaly. The diagnosis of primary Epstein-Barr viral infection was eventually made by specific serologic tests. The patients's fever subsided 6 weeks later and pneumonia was recovered around this time. Liver function tests returned near normal 2 months later and ultrasonography of gallbladder was normal at this time.

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