Building of Pediatric COVID-19 Module Clinic: A Novel Operation Model in Response to COVID-19 Pandemic

In mid-2022, as the wave of pediatric coronavirus disease 2019 (COVID-19) cases escalated in South Korea, a public-private partnership was made to establish a Pediatric COVID-19 Module Clinic (PMC). We describe the utilization of the first prototype children’s modular clinic in Korea University Anam Hospital functioning as the COVID-19 PMC. Between August 1 and September 30, 2022, a total of 766 children visited COVID-19 PMC. Daily number of patient visits to the COVID-19 PMC ranged between 10 and 47 in August; and less than 13 patients per day in September 2022. Not only the model provided timely care for the COVID-19 pediatric patients, but it also enabled safe and efficacious care for the non-COVID-19 patients in the main hospital building while minimizing exposure risk to severe acute respiratory syndrome coronavirus 2 transmission. Current description highlights the importance of spatial measures for mitigating in-hospital transmission of COVID-19, in specifically on pediatric care.

Neonatal Risk Factors for Growth Retardation in Infants With Congenital Heart Disease

Background@#While the association of congenital heart disease (CHD) and growth retardation (GR) is known, data remain limited. This study investigated the incidence of GR and its neonatal risk factors in patients with CHD using nationwide population-based claims data.Method: The study population was extracted from Korean National Health Insurance Service claims data from January 2002 to December 2020. We included patients diagnosed with CHD under one year of age. GR was defined as an idiopathic growth hormone deficiency or short stature on the claims data. We investigated the neonatal risk factors for GR. @*Results@#The number of patients diagnosed with CHD within the first year of birth was 133,739. Of these, 2,921 newborns were diagnosed with GR. The cumulative incidence of GR was 4.8% at 19 years of age for individuals diagnosed with CHD at infancy. In the multivariable analysis, the significant risk factors for GR were preterm birth, small for gestational age, low birth weight, respiratory distress, bronchopulmonary dysplasia, bacterial sepsis, necrotizing enterocolitis, feeding problems and cardiac procedure. @*Conclusion@#Several neonatal conditions were significant risk factors for GR in CHD patients, and appropriate monitoring and treatment programs are required in CHD neonates with these factors. Considering this study is limited to claims data, further studies are warranted, including genetic and environmental factors affecting GR in CHD patients.

Association between the Use of Diuretics and Size Reduction in Pediatric Atrial Septal Defect

Background and Objectives@#While diuretics are sometimes used in atrial septal defect (ASD) treatment, their effect on ASD size reduction remains unclear. We aimed to evaluate the efficacy of diuretics in ASD size reduction in pediatric patients. @*Methods@#We retrospectively reviewed the medical records of patients with secundum ASD (size ≥10 mm), between 2005 and 2019. Patients were divided into two groups based on the diuretic administration. @*Results@#Of the 73 enrolled patients, 40 received diuretics. The initial age at ASD diagnosis (2.8±1.7 vs. 2.5±2.0 years, p=0.526) and follow-up duration (22.3±11.4 vs. 18.7±13.2 months, p=0.224) were not significantly different between the groups. The ASD diameter at the initial diagnosis (13.7±2.0 vs. 13.5±3.4 mm, p=0.761) and the indexed ASD diameter (25.5±5.9 vs. 26.9±10.3 mm/m2 , p=0.493) were also not significantly different between two groups. The ASD diameter significantly increased in the non-diuretic group during follow-up (0.0±2.9 vs. +2.6±2.0 mm, p<0.001). The indexed ASD diameter significantly decreased in the diuretic group during follow-up (−5.7±6.5 vs. +0.2±3.9 mm/m 2 , p<0.001). In the linear mixed model analysis, diuretic use was associated with ASD diameter decrease (p<0.001) and indexed ASD diameter reduction (p<0.001) over time. Device closure was more frequently performed in the diuretic (75.0%) than in the non-diuretic group (39.4%). @*Conclusions@#Patients receiving diuretics are less likely to undergo surgery. The diuretics administration may be associated with the use of smaller ASD devices for transcatheter treatment through ASD size reduction.

Relationship between Waist Circumference and Cardiovascular Risk Factors in Adolescents: Analysis of the Korea National Health and Nutrition Examination Survey Data

Background and Objectives@#High waist circumference (WC) is associated with increased cardiovascular risk (CVR) in adulthood. We investigated this association in adolescents. @*Methods@#We performed a cross-sectional analysis of data for 10–18-year-olds included in the Korea National Health and Nutrition Examination Survey (KNHANES) (2005–2014). The association between WC and CVR factors was evaluated. We analyzed this relationship according to age. @*Results@#We analyzed 8,153 participants (4,319 boys and 3,834 girls) from the KNHANES. High WC was associated with increased incidence of CVR factors: hypertension (odds ratio [OR], 3.5 in boys, 1.9 in girls), high total cholesterol (OR, 3.9 in boys, 1.9 in girls), high triglycerides (OR, 4.9 in boys, 3.2 in girls), high low-density lipoprotein (LDL) cholesterol (OR, 5.0 in boys, 1.8 in girls), low high-density lipoprotein (HDL) cholesterol (OR, 2.6 in boys, 3.0 in girls), and hyperglycemia (OR, 2.8 in girls). In boys, the association between high WC and hypertension, high triglycerides, and low HDL cholesterol was noted in early adolescence. High WC was associated with high total cholesterol and high LDL cholesterol in middle adolescence. In girls, high WC was correlated with high total cholesterol, high triglycerides, and low HDL cholesterol in early adolescence. High WC was shown to be associated with hyperglycemia in middle adolescence, and with hypertension and high LDL cholesterol in late adolescence. @*Conclusions@#High WC in adolescents is associated with increased CVR. The timing of this association differs according to sex and CVR factors.

The correlation of depression with Internet use and body image in Korean adolescents / 소아과

PURPOSE: To examine the correlation of depression with Internet use and body image perception, and to analyze the risk factors of depression in a total of 920 students in Seoul, Korea. METHODS: Students were recruited by contacting school principals and teachers and were encouraged to fill out a self-report questionnaire designed specifically for this study in July of 2008. RESULTS: Female participants had an increased risk for depression than did male participants (adjusted odds ratio [aOR], 1.790; 95% confidence interval [CI], 1.330–2.410, P<0.001). Older students were more susceptible to depression (aOR, 1.246; 95% CI, 1.115–1.392, P<0.001). Longer daily Internet use and more frequent Internet use were analyzed as risk factors for depression. No physical activity was a risk factor for depression (aOR, 0.392; 95% CI, 1.264–4.526, P=0.014). Dissatisfaction with one's body image increased the risk for depression (aOR, 1.373; 95% CI, 1.169–1.613; P<0.001). Obesity and perception of body image showed no significant relationship with increased risk for depression. CONCLUSION: Prevalence of depression was 13.8% in adolescents in Seoul, Korea, in July 2008. Female sex, age, daily Internet use duration, weekly Internet use frequency, physical activity, and dissatisfaction with one's body image independently increased risk of depression.

The correlation of depression with Internet use and body image in Korean adolescents / 소아과

PURPOSE: To examine the correlation of depression with Internet use and body image perception, and to analyze the risk factors of depression in a total of 920 students in Seoul, Korea. METHODS: Students were recruited by contacting school principals and teachers and were encouraged to fill out a self-report questionnaire designed specifically for this study in July of 2008. RESULTS: Female participants had an increased risk for depression than did male participants (adjusted odds ratio [aOR], 1.790; 95% confidence interval [CI], 1.330–2.410, P<0.001). Older students were more susceptible to depression (aOR, 1.246; 95% CI, 1.115–1.392, P<0.001). Longer daily Internet use and more frequent Internet use were analyzed as risk factors for depression. No physical activity was a risk factor for depression (aOR, 0.392; 95% CI, 1.264–4.526, P=0.014). Dissatisfaction with one's body image increased the risk for depression (aOR, 1.373; 95% CI, 1.169–1.613; P<0.001). Obesity and perception of body image showed no significant relationship with increased risk for depression. CONCLUSION: Prevalence of depression was 13.8% in adolescents in Seoul, Korea, in July 2008. Female sex, age, daily Internet use duration, weekly Internet use frequency, physical activity, and dissatisfaction with one's body image independently increased risk of depression.

Congenital miliary tuberculosis in an 18-day-old boy / 소아과

Congenital tuberculosis (TB) is a rare disease that is associated with high mortality. Mycobacterium tuberculosis, the causative agent, may be transmitted from the infected mother to the fetus by the transplacental route or by aspiration of infected amniotic fluid. Clinical symptoms and signs are not specific. Miliary patterns are the most common findings in the chest X-rays of many infants with congenital TB. In this case, an 18-day-old boy had jaundice on the fifth day of birth, and fever and respiratory distress appeared on the 18th day. Chest X-ray showed diffuse fine bilateral infiltration. Clinically, pneumonia or sepsis was suspected. Respiratory symptoms and chest X-ray findings worsened despite empirical antibiotic therapy. The lungs showed miliary infiltration suggestive of TB. Gastric aspirates were positive for M. tuberculosis. Respiratory distress and fever were gradually improved after anti-TB medication. Congenital TB is difficult to detect because of minimal or no symptoms during pregnancy and nonspecific symptoms in neonates. Hence, clinicians should suspect the possibility of TB infection even if neonates have non-specific symptoms. Early diagnosis and meticulous treatment are required for the survival of neonates with TB.