ABSTRACT
PURPOSE: Adherence is a major component of successful medical treatment. However, non-adherence remains a barrier to effective delivery of healthcare worldwide. METHODS: Twenty healthcare facilities (secondary or tertiary hospitals) belonging to the Korean Academy of Pediatric Allergy and Respiratory Diseases (KAPARD) participated. Questionnaires were given to patients currently receiving treatment in the form of inhalant useor oral intake or transdermal patch for mild to moderate asthma. RESULTS: A total of 1,838 patients responded to the questionnaire. Mean age was 5.98 ± 3.79 years (range: 0-18 years). With help from their caregivers, the percentage of patients that answered “taking as prescribed” was 38.04% for inhalant users, 50.09% for oral medication users and 67.42% for transdermal users. Transdermal patch users had significantly greater adherence compared to the other 2 groups (P < 0.001). The 34.15% of inhalant users, 70.33% of oral medication users and 93.00% of transdermal patch users felt that their medication delivery system was “Easy” or “Very easy” to use (P < 0.001). “Method of administration” was deemed to be the most difficult part of the treatment regimen to follow, and 76.7% of patients preferred once-daily administration (i.e., “Frequency of administration”). CONCLUSIONS: Asthma medication adherence in young children was found to be better in the transdermal patch group. This may be due to requiring fewer doses and easy to follow instructions. From an adherence point of view, the transdermal patch seems more useful for long-term asthma control in children compared to oral or inhaled medicine.
Subject(s)
Child , Humans , Asthma , Caregivers , Delivery of Health Care , Hypersensitivity , Korea , Medication Adherence , Transdermal PatchABSTRACT
This study represents the first epidemiological study based on the national registry of primary immunodeficiencies (PID) in Korea. Patient data were collected from 23 major hospitals. A total of 152 patients with PID (under 19 yr of age), who were observed from 2001 to 2005, have been entered in this registry. The period prevalence of PID in Korea in 2005 is 11.25 per million children. The following frequencies were found: antibody deficiencies, 53.3% (n = 81), phagocytic disorders, 28.9% (n = 44); combined immunodeficiencies, 13.2% (n = 20); and T cell deficiencies, 4.6% (n = 7). Congenital agammaglobulinemia (n = 21) and selective IgA deficiency (n = 21) were the most frequently reported antibody deficiency. Other reported deficiencies were common variable immunodeficiencies (n = 16), X-linked agammaglobulinemia (n = 15), IgG subclass deficiency (n = 4). Phagocytic disorder was mostly chronic granulomatous disease. A small number of patients with Wiskott-Aldrich syndrome, hyper-IgE syndrome, and severe combined immunodeficiency were also registered. Overall, the most common first manifestation was pneumonia. This study provides data that permit a more accurate estimation PID patients in Korea.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Young Adult , Agammaglobulinemia/congenital , Age Distribution , Common Variable Immunodeficiency/epidemiology , Genetic Diseases, X-Linked/epidemiology , IgA Deficiency/epidemiology , IgG Deficiency/epidemiology , Immunologic Deficiency Syndromes/epidemiology , Job Syndrome/epidemiology , Prevalence , Surveys and Questionnaires , Registries , Republic of Korea/epidemiology , Severe Combined Immunodeficiency/epidemiology , Sex Distribution , Wiskott-Aldrich Syndrome/epidemiologyABSTRACT
As known by other name (natural immunity), the innate immune system comprises all those mechanisms for dealing with infection that are constitutive or built in, changing little with age or with experience of infection. Though in some ways less sophisticated than adaptive immunity, innate immunity should not belittled, since it has evidently protected thousands of species of invertebrates sufficiently to survive for up to 2 billion years. In the innate immune system, molecules of both cellular and humoral types are involved, corresponding to the need to recognize and dispose of different types of pathogen, to promote inflammatory responses and to interact to the adaptive immune system. A major features of innate immunity are the presence of the normal gut flora, complements, macrophages, dendritic cells, natural killer cells and many cytokines that can block the establishment of infection. Both phagocytic cells and complement system have tremendous potential for damaging host cells, but fortunately they are normally only triggered by foreign materials, and usually most of their destructive effects are focussed on the surface of these or in the safe environment of the phagolysosome. This article addreses the comprehensive mechanisms of the major components of the innate immune system to prevent the infection.
ABSTRACT
Langerhans cell histiocytosis is a rare disease in which the Langerhans cells proliferate abnormally, like a cancer, and involve various tissues and organs, such as skin, bone, lung, lymph node, liver and spleen. Especially, in the younger age, it usually involves more organs and tissues, sometimes including the thymus. But isolated involvement of thymus is very rare. We report an 11-month-old-girl with an isolated thymic involvement of Langerhans cell histiocytosis with a brief review of related literatures.
Subject(s)
Histiocytosis, Langerhans-Cell , Langerhans Cells , Liver , Lung , Lymph Nodes , Rare Diseases , Skin , Spleen , Thymus GlandABSTRACT
PURPOSES: Radiologic findings of hands in Turner syndrome(TS) which have been reported were metacarpal sign(MS), carpal sign(CS), phalangeal sign(PS), osteopenia, and delayed bone maturation. The aim of this study is to evaluate the difference of radiologic findings in TS, idiopathic short stature(ISS), and growth hormone deficiency(GHD). METHODS: Sixty girls with short stature were studied for chromosome analysis, and growth hormone provocation test. Simple radiography of hands was also used in this study. They were divided into three groups; 25 cases of TS(45, XO, 13 cases; variants, 12 cases), 24 cases of ISS, and 11 cases of GHD. MS was the distance between the line drawn tangential to the heads of the fourth and fifth metacarpal bones and the distal end of the third metacarpal head. CS was the angle between the line tangential to scaphoid and lunate and the line tangential to lunate and triquetrum. PS was the difference between the sum of the length of distal and proximal phalanges of the fourth finger and the length of the fourth metacarpus. Frequency of osteopenia and the shortening of the fifth middle phalanx among three groups were compared. RESULTS: MS was 0.06+/-4.66 mm in TS, -1.96+/-1.83 mm in ISS, and -2.63+/-30 mm in GHD. CS was 116.54+/-11.52degreein TS, 129.42+/-5.52degreein ISS, and 125.54+/-7.22degreein GHD. PS was 0.52+/-0.34 mm in TS, 0.38+/-0.20 mm in ISS, and 0.33+/-0.20 mm in GHD. There were statistically significant differences between TS and ISS, between TS and GHD, respectively in MS, CS, and PS(P<0.05). There were no significant differences in MS, CS, and PS between 45, XO and variants of TS. Osteopenia was observed in 92.3% of TS, and 54.2% of ISS, and 81.8% of GHD. Shortening of the fifth middle phalanx was observed in 56.0% of TS, 25.0% of ISS, and 45.5% of GHD. CONCLUSION: Simple radiologic findings of hands are helpful in differential diagnosis of TS and other short stature children.