ABSTRACT
Refractory status epilepticus (RSE) is defined as seizure activity that continues after treatment with conventional anticonvulsants. Mortality rates of range from 2% to 100%. RSE are associated with significant morbidity and high mortality as evidenced by older age of the patient, acute etiology for the seizure, no previous history of seizures, low initial Glasgow Coma Scale, and the significant duration of the RSE. An intravenous valproic acid (VPA) was suggested as a useful drug in controlling RSE. A continuous infusion VPA was an efficient method of rapidly achieving VPA concentrations in the upper region of the therapeutic range while minimizing adverse effects. A 10-year-old female suffered a generalized tonic clonic seizure that developed into refractory status epilepticus. Her Glasgow Coma Scale was deteriorated to 4. Status epilepticus was refractory to phenytoin, phenobarbital, midazolam, thiopental. After 4days of unsatisfactory control of seizure activity, high dose VPA was administered for 2 months. The clinical and electrolgraphic seizure improved and the patient has made an satisfactory neurologic recovery
Subject(s)
Child , Female , Humans , Anticonvulsants , Glasgow Coma Scale , Midazolam , Phenobarbital , Phenytoin , Seizures , Status Epilepticus , Thiopental , Valproic AcidABSTRACT
Although transfusion of blood and plasma products are accepted as the principle means of transmission of HCV, other parenteral methods, such as acupuncture, tattooing needles, piercing, and surgery are possible methods of transmission of HCV. We managed a case of chronic hepatitis C acquired through ear piercing and acupuncture. A 10-year old girl presented with nausea, abdominal pain, and anorexia for 1 month. Her laboratory finding showed the following: AST/ALT, 865/1,290 IU/L; positive anti-HCV Ab; and HCV RNA. One year previously, she was treated with acupuncture for an ankle sprain and 2 years previously, she had her ears pierced. Laboratory findings of family members showed AST/ALT in the normal ranges, and negative anti-HCV Ab and HCV RNA. The pathologic findings of a liver biopsy revealed chronic hepatitis with mild lobular activity, moderate porto-periportal activity, and portal fibrosis. She was treated with pegylated interferon alpha-2a and oral ribavirin for 6 months, after which the clinical symptoms and laboratory findings improved.
Subject(s)
Animals , Humans , Abdominal Pain , Acupuncture , Ankle , Anorexia , Biopsy , Body Piercing , Ear , Fibrosis , Hepatitis C , Hepatitis C, Chronic , Hepatitis, Chronic , Interferons , Liver , Nausea , Needles , Plasma , Reference Values , Ribavirin , RNA , Sprains and Strains , TattooingABSTRACT
PURPOSE: This study was designed to characterize the nutritional status and assess obesity to determine the relationship between obesity and serum lipid profiles in 6~7 year old children. METHODS: In 2007, we surveyed 483 children (233 boys and 250 girls) aged 6~7 years. The total cholesterol, triglyceride levels and HDL-cholesterol were measured in the fasting state. Dietary information was obtained by a questionnaire. RESULTS: The prevalence of obesity was 9.9%. There was no significant difference between genders. The mean caloric intake was 1,781 kcal in boys and 1,640 kcal in girls. The prevalence of excessive calories was 33% in boys and 30% in girls. The prevalence of a total cholesterol > or =200 mg/dL was 8.4%, TG > or =130 mg/dL was 5.0%, LDL-cholesterol > or =130 mg/dL was 3.1%, and HDL-cholesterol or =130 mg/dL the odds ratio was 4.08; for LDL-cholesterol > or =130 mg the odds ratio was 2.85; for a TC/HDL-cholesterol > or =4.0 the odds ratio was 1.16. The BMI and triglyceride levels in the group with hypertension were higher than control group (p<0.05). There were significant positive correlations between the BMI and blood pressure as well as the LDL-cholesterol and triglycerides (p<0.05). The BMI was not correlated with the mean caloric intake or nutrition. CONCLUSION: The prevalence of hypertension and hyperlipidemia in 6~7 year old children was significantly related to an increased obesity index. The management of obesity in 6~7 year old children should include a reduction in the risk for hyperlipidemia and hypertension.