Ambulatory Blood Pressure Monitoring and Blood Pressure Load in Obese Children

BACKGROUND AND OBJECTIVES: This study was aimed at evaluating the significance of blood pressure (BP) load in ambulatory blood pressure monitoring (ABPM) in obese children and adolescents. SUBJECTS AND METHODS: ABPM was conducted for 60 selected patients who had visited Sunlin Hospital between January 2008 and August 2008. Patients were classified into 3 groups; an obese group whose body mass index (BMI) was > the 95th percentile, an overweight group whose BMI was > the 85th percentile but less than the 95th percentile, and a normal group whose BMI was below the 85th percentile. Overall mean BP, day and night BP and BP load were measured by ABPM. RESULTS: Of the 60 patients, twenty-seven children belonged to the obese group, 9 and 24 to the overweight and the normal group, respectively. Among the three groups, the overall average systolic and diastolic BP, daytime diastolic BP, and systolic BP loads in daytime and nighttime were statistically different. Comparing the obese group with the normal group, systolic BP loads in daytime and nighttime in the obese group were significantly higher than those in the normal group. Also, the obese group had more patients whose BP loads were over 25% greater than the normal group while the difference in the number of patients with overall hypertension was not significantly different. CONCLUSION: Assessment of children's BP through assessment of BP load is a more detailed and precise tool than assessment through mean BP using ABPM and BP can be better controlled using measurement of BP load.

Antibiotic Sensitivity Pattern of Pathogens from Children with UTI

PURPOSE: We studied the degree of changes in antibiotic sensitivity toward causative organisms, prevalence and clinical manifestations of extended-spectrum beta-lactamase(ESBL)- producers of urinary tract infection(UTI) for a period of three years. This serves to provide useful information in selecting adequate drugs for the treatment of UTI. METHODS: We recruited 137 patients who grew more than 105 CFU/mL in their urine culture among 250 patients who visited and were admitted to Handong University's Sunlin Hospital for UTI treatment from January 2003 to December 2005. We retrospectively analyzed the data from the medical records. RESULTS: The common pathogenic organisms were Escherichia coli(65.0%), Klepsiella pneumoniae(14.0%), Enterococcus faecalis(5.8%) and Proteus vulgaris(2.9%) in consecutive order. The prevalence of ESBL-producers among isolated E. coli and K. pneumoniae was 4.5%(4 cases) and 14.3%(2 cases), respectively. The antibiotic sensitivity rates of E. coli were relatively high to amikacin(100%), imipenem(100%), ceftriaxone(95.5%) and tobramycin(91.4%) while relatively low to TMP/SMZ(55.4%), ampicillin/sulbactam(29.4%) and ampicillin (24.2%). CONCLUSION: The use of ampicillin, ampicillin/sulbactam and TMP/SMZ, which have been the first choices in the treatment of UTI, should be reconsidered due to the low sensitivity rates towards these antibiotics. Due to the high incidence and antibiotic tolerance of ESBL that might have risen from the development of new antibiotics and increased antibiotic use, it is necessary to consider changing the standard antibiotics that have been used in the treatment of UTI.