RESUMO
PURPOSE: This study investigated factors affecting recurrent wheezing in infants, focusing on whether or not respiratory syncytial virus (RSV) infections in children <3 years of age induce recurrent wheezing later in life. METHODS: The inclusion criteria were children <3 years of age who were hospitalized for an RSV infection from January 2006 to December 2009. We evaluated lateral flow immunochromatography (RSV Respi-Strip test). Subjects with at least three episodes of physician-verified wheezing were defined as recurrent wheezers. A group of 79 children hospitalized with RSV infections were compared with a matched control group. The following data were collected: age, gender, admission duration, gestational age, obesity, history of atopic dermatitis, parental history of allergic diseases, exposure to passive smoking, exposure to indoor animals, and daycare attendance. RESULTS: Rates of obesity and exposure to passive smoking were significantly higher in the RSV group than those in the control group. The frequency of recurrent wheezing in the RSV group (39.2%) was higher than that in the control group (10.1%). Compared to the control group, recurrent wheezing occurred 5.76 times more often in the RSV group, 2.49 times more often in males, and 2.41 times often in patients with a parental history of allergic diseases. CONCLUSION: The results demonstrated that RSV infection is significantly associated with recurrent wheezing, and that the risk is higher in male children and in children with a parental history of allergic diseases.
Assuntos
Animais , Criança , Humanos , Lactente , Masculino , Dermatite Atópica , Idade Gestacional , Cromatografia de Afinidade , Obesidade , Pais , Sons Respiratórios , Infecções por Vírus Respiratório Sincicial , Vírus Sinciciais Respiratórios , Poluição por Fumaça de TabacoRESUMO
PURPOSE: Febrile convulsions are a common pediatric neurological disease, and it is important to prevent such a disease by controlling the risk factors that may recur. A recent report states that influenza virus infections have a high probability of a relationship with febrile convulsions; therefore, it is necessary to identify the clinical properties of febrile convulsions in relation to domestic influenza virus infections. METHODS: Between November 2005 and February 2008, children hospitalized because of febrile convulsions and subsequently confirmed to have influenza infections were enrolled as subjects (patient group, n=11). The control subjects were those admitted with influenza virus infections but no febrile convulsions (control group 1, n=46) and those who developed febrile convulsions without influenza virus infection (control group 2, n=53). RESULTS: The patient group showed a higher maximum body temperature (39.3+/-0.5degrees C), more histories of past febrile convulsions (72.7%), and a shorter total duration of fever (2.9+/-1.2 days) than control group 1. When multivariate analysis was performed, the probability of febrile convulsions was found to be as high as 225.9 times in patients who had influenza virus infections with a past history of febrile convulsions (OR=225.9, 95% CI: 1.7-4780.0, P<0.05). When patients with febrile convulsions were compared based on the symptoms of influenza virus infections, the patient group showed a shorter duration of fever (0.9+/-0.7 days) before convulsion than control group 2; these convulsions were mostly a recurrence of febrile convulsions. When multivariate analysis was performed, the cases with a past history of febrile convulsions showed 5.5 times (OR=5.5, 95% CI: 1.2-25.1, P=0.03) the probability of convulsions when infected with the influenza virus, and this probabilit. decreased by 0.3 times over one-day increments of the febrile period until febrile convulsions (95% CI: 0.1-0.9, P=0.02). Maximum body temperature, total duration of fever, family history of febrile convulsions, and complex febrile convulsions did not show a statistical significance. CONCLUSION: In cases of pediatric influenza virus infection, the past history of febrile convulsions could be identified within the risk factor of recurrent febrile convulsions. Therefore, influenza vaccination of children having a past history of febrile convulsions will be helpful to avoid the recurrence of these convulsions.
Assuntos
Criança , Humanos , Temperatura Corporal , Febre , Influenza Humana , Análise Multivariada , Orthomyxoviridae , Recidiva , Fatores de Risco , Convulsões , Convulsões Febris , VacinaçãoRESUMO
PURPOSE: To evaluate mortality and morbidity of very low birth weight infants(VLBW infants) born in the Busan area from 1996 to 2005. METHODS: A total of eight neonatal intensive care units (4 university hospitals and 4 general hospitals) in Busan participated in this study. A total of 1,414 VLBW infants were divided into three groups: period I, 1996 to 2000; period II, 1999 to 2002; period III, 2003 to 2005, based on date of birth. We performed a retrospective review of medical records of VLBWinfants and compared the survival rate, morbidity and mortality over the three periods. RESULT: The number of VLBW infants admitted to 8 NICUs in 1996-2005 was a total of 1,414 (1.3% incidence, mean gestational age 29.1+/-2.7 wk, mean birth weight 1158+/-235 g), including 361 (24.7%) extremely low birth weight infants (ELVW infants) who were less than 1,000 g at birth weight. Overall survival rate of VLBW infants was 66.1%. The survival rate of VLBW infants increased significantly over the three periods (period I:57.6%, period II:67.8%, period III:75.7%, P<0.01). Overall survival rate of ELBW infants was 33.8%, and increased from 26.4% in period I to 44.2% in period III (P<0.01). The incidence of respiratory distress syndrome was 45.1%; patent ductus arteriosus, 16.4%; bronchopulmonary dysplasia, 13.1%; blood culture positive sepsis, 12.7%; necrotizing enterocolitis, 6.6%; severe intracranial hemorrhage, 6.5%; and severe retinopathy of prematurity, 5.9%. The main causes of death were respiratory distress syndrome and sepsis. CONCLUSION: Overall survival rate of very low birth weight infant in Busan area during the last 10 years was 66.1%, and increased significantly over the three periods.
Assuntos
Humanos , Lactente , Recém-Nascido , Peso ao Nascer , Displasia Broncopulmonar , Causas de Morte , Permeabilidade do Canal Arterial , Enterocolite Necrosante , Idade Gestacional , Hospitais Universitários , Incidência , Recém-Nascido de Baixo Peso , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal , Hemorragias Intracranianas , Prontuários Médicos , Mortalidade , Parto , Retinopatia da Prematuridade , Estudos Retrospectivos , Sepse , Taxa de SobrevidaRESUMO
PURPOSE: Interleukin 18 (IL-18) is now recognized as an important regulator of innate and acquired immune response. IL-18 is a proinflammatory cytokine which induces IFN-gamma, TNF-alpha, Granulocyte-macrophage Colony-stimulating factor (GM-CSF), IL-1, IL-4 and IL-10, to activate killing by lymphocytes, and to up-regulate the expression of certain chemokine receptors. The authors hypothesized that elevated concentration of IL-18 was related to the pathophysiology of KS. The aims of the present study was to evaluate serial changes of serum IL-18 level in acute and subacute phase of KD, and Comparison of serum IL-18 levels, biochemical profiles and the duration of fever. METHODS: We determined simultaneously the serum concentrations of IL-18 and C-reactive protein (CRP) as well as the white blood cell (WBC) count in 23 patients with acute and subacute phase of KD, 23 with respiratory tract infection (febrile controls) and 10 healthy children (afebrile controls). RESULTS: Acute-phase KD patients showed a significantly higher mean IL-18 value (492.80+/-143.70 pg/mL) than that of subaute-phase KD patients(230.67+/-144.13 pg/mL) and afebrile control (223.97+/-164.12 pg/mL)(p<0.05). Subacute-phase KD patients showed a significantly lower level of IL-18 compared to febrile control(519.77+/-242.05 pg/mL)(P<0.05). The IL-18 values in the acute-phase patients showed a positive correlation with CRP (r=0.413, P=0.030), but there were no other correlations between serum IL-18 value and other profiles. CONCLUSION: The results showed increased IL-18 values in the acute phase and normal values in subacute phase of KD. but IL-18 values were not directly correlated with WBC count, CRP and the duration of fever except between IL-18 value and CRP in the acute phaseof KD. The results suggest that IL-18 pathways were activated in the acute phase of KD, and IL-18 production may not be associated with the severity of inflammation in KD.
Assuntos
Criança , Humanos , Proteína C-Reativa , Febre , Fator Estimulador de Colônias de Granulócitos e Macrófagos , Homicídio , Inflamação , Interleucina-1 , Interleucina-10 , Interleucina-18 , Interleucina-4 , Leucócitos , Linfócitos , Síndrome de Linfonodos Mucocutâneos , Receptores de Quimiocinas , Valores de Referência , Infecções Respiratórias , Fator de Necrose Tumoral alfaRESUMO
PURPOSE: We evaluated the occurrence of renal scarring in children with unilateral vesicoureteral reflux (VUR), and the relationships between renal scar formation and risk factors such as VUR, duration of fever, acute-phase reactant, age, and sex. METHODS: We retrospectively analyzed the data of 35 children newly diagnosed with unilateral vesicoureteral reflux after urinary tract infection (UTI) in Wallace Memorial Baptist Hospital between January 1996 and December 2004. Ultrasonography, Erythrocyte sedimentation rate (ESR), and C- reactive protein (CRP) were performed initially. Voiding cystourethrography (VCUG) was performed 1 to 3 weeks after treatment with UTI. (99m) Tc-dimercaptosuccinic acid (DMSA) scan was performed 4 to 6 months after treatment. RESULTS: Scintigraphic renal damage was present in 29 percent of the refluxing and in 3 percent of the nonrefluxing kidneys (P< 0.05). The severity of VUR was significantly correlated with renal scar formation (P< 0.05). The duration of fever before treatmen (5.0+/-1.3 vs 2.6+/-1.3) and prolonged fever of over 5 days were significantly different between renal scar group and non-renal scar group (P< 0.05). ESR (56.3+/-23.8 vs 27.9+/-18.1 mm/hr, P< 0.05) and CRP (12.8+/-7.3 vs 3.9+/-3.8 mg/dL, P< 0.05) at the diagnosis of UTI in the renal scar group were higher, compared to those of the non-renal scar group. There were no significant differences in age and sex between the two groups. CONCLUSION: The presence and grade of VUR, the duration of fever before treatment, prolonged fever over 5 days, ESR, and CRP were risk factors for renal scarring, irrespective of age and sex. Diagnosis and management of VUR, in children with UTI, is important to prevent renal scars.
Assuntos
Criança , Humanos , Sedimentação Sanguínea , Cicatriz , Diagnóstico , Febre , Rim , Protestantismo , Estudos Retrospectivos , Fatores de Risco , Ultrassonografia , Infecções Urinárias , Refluxo VesicoureteralRESUMO
PURPOSE: To evaluate mortality and morbidity of very low birth weight (VLBW) infants born in Busan from 1996 to 2001. METHOD: Seven neonatal intensive care units (including 3 university hospitals and 4 general hospitals) in Busan participated for this study. We performed retrospective review of 756 VLBW infants who were born in this area during study period was done to assess their mortality and morbidity. RESULT: The total number of VLBW infant was 756 (incidence: 0.97%, mean gestational age: 29.5 +/- 2.9 wk, mean birth weight: 1165+/-232 g) including 187 extremely low birth weight infants who were less than 1, 000 g birth weight (24.7%). The survival rate was 61.0% (461 of 756). It increased from 56.4% in early period (1996 to 1998) to 65.2% in late period (1999 to 2001) (P<0.01). The incidence of respiratory distress syndrome was 61.5% (466 of 756), patent ductus arteriosus 12.3% (93 of 756), blood culture positive sepsis 10.2% (77 of 756), bronchopulmonary dysplasia 9.3% (70 of 756), severe intracranial hemorrhage 6.5% (49 of 756), necrotizing enterocolitis 4.9% (37 of 756), severe retinopathy of prematurity 3.7 % (28 of 756). The main causes of death were respiratory distress syndrome and sepsis. CONCLUSION: The survival rate of VLBW infant in Busan area during recent 6 years was 61.0%, which is lower than other single unit result of our country, recent Japanese or North American data. We think both modernized facilities in NICU and well-trained medical personnel are needed to improve survival.
Assuntos
Humanos , Lactente , Recém-Nascido , Povo Asiático , Peso ao Nascer , Displasia Broncopulmonar , Causas de Morte , Permeabilidade do Canal Arterial , Enterocolite Necrosante , Idade Gestacional , Hospitais Universitários , Incidência , Recém-Nascido de Baixo Peso , Recém-Nascido de muito Baixo Peso , Unidades de Terapia Intensiva Neonatal , Hemorragias Intracranianas , Mortalidade , Retinopatia da Prematuridade , Estudos Retrospectivos , Sepse , Taxa de SobrevidaRESUMO
PURPOSE: This study was done to analyze the changes in the clinical conditions and the diagnosis of hypertrophic pyloric stenosis. METHODS: We report a retrospective clinical analysis of 39 patients with hypertrophic pyloric stenosis from Jan. 1992 to Aug. 2001. The age and sex distribution, family and birth history, clinical symptoms, the ultrasonographic and the operative sizes of pyloric canals were compared. RESULTS: The body weight was below the 3 percentile at admission in eight cases(20.5%). "Olive like mass" in right upper quadrant was palpated during physical examination in 23 cases(59%) and gastric peristaltic wave observed in six cases(15%). The ultrasonographic measurements showed that the pyloric muscle thickness to be 4.95+/-0.99 mm(mean+/-SD), pyloric diameter 14.42+/-2.64 mm, and pyloric length 20.17+/-3.92 mm. Fredet-Ramstedt pyloromyotomy was employed in all cases. The operative measurements of the pyloric muscle thickness was 5.11+/-1.01 mm, pyloric diameter 15.01+/-2.47 mm, and pyloric length 22.32+/-3.43 mm. CONCLUSION: There was no significant difference between the ultrasonographic and operative measurements. Currently, the hypertrophic pyloric stenosis patients showed lesser clinical hallmarks of the disease. The earlier diagnosis using imaging studies before development of significant metabolic abnormalities is becoming an important factor that change the future outcomes of hypertrophic pyloric stenosis.
Assuntos
Humanos , Peso Corporal , Diagnóstico , Exame Físico , Estenose Pilórica Hipertrófica , História Reprodutiva , Estudos Retrospectivos , Distribuição por SexoRESUMO
Acute vanishing bile syndrome is a cause of progressive cholestasis. It is most often drug or toxin related. It's pathogenesis is unknown. Stevens-Johnson syndorme is a well-recognized immune complex-mediated hypersensitivity reaction. It is induced by drug or infection. It has classic systemic, mucosal, and dermatologic manifestations. We report a case of a 14 years old female suffering from Stevens-Johnson syndrome plus vanishing bile duct syndrome associated with ibuprofen use. We report the case with a brief review of its related literature.
Assuntos
Adolescente , Feminino , Humanos , Ductos Biliares , Bile , Colestase , Hipersensibilidade , Ibuprofeno , Síndrome de Stevens-JohnsonRESUMO
We experienced a case of isolated fetal pleural effusion diagnosed by antenatal ultrasonogram in the 33th week of gestational age. Chest PA at birth showed massive pleural effusion in both lungs. The serous pleural fluid changed to a milky nature after feeding so we diagnosed it as congenital chylothorax. The infant was managed by chest tube drainage, NPO & TPN with good response and was discharged on the 28th hospital day. We report the case with a brief review of its related literature.
Assuntos
Humanos , Lactente , Recém-Nascido , Tubos Torácicos , Quilotórax , Drenagem , Idade Gestacional , Recém-Nascido Prematuro , Pulmão , Parto , Derrame Pleural , Tórax , UltrassonografiaRESUMO
BACKGROUND: Cancer is the second cause of childhood death following accident, and leukemia is the most frequent childhood cancer in Korea. For the desirable control of childhood leukemia, of which the mortality is still high, the basic data for the incidence has a great importance. This is the second report from the data during 1991~1995 following the first one that analyzed the data from 328 cases of childhood leukemia during 1981~1990 in the same area, Pusan city, Korea. METHODS: The data were obtained from 138 new cases(84 males and 54 females from 0 to 15 years old) of childhood leukemia who had been living in the city of Pusan and were admitted to the 4 university hospitals and 11 general hospitals from 1991 to 1995. The cases were confirmed by CBC and bone marrow examination. RESULTS: The crude annual incidence rate per 100,000 population varied 1.50~5.30, 2.59~6.00 and 1.58~2.61 in the age group of 0~4 years, 5~9 years and 10~14 years, respectively. The standardized annual incidence rate per 100,000 population varied from 2.05 to 3.46(male 2.96~4.89, female 0.98~3.57). Sex ratio(male to female) was 1.58:1, 1.44:1, and 1.82:1 in total cases, ALL and AML, respectively, while incalculable in CML. By the major types of childhood leukemia, the cases were composed of 105 ALL (76.1%), 31 AML(22.5%), 2 CML(1.4%). CONCLUSION: It was concluded that the annual incidence rate of childhood leukemia per 100,000 population in Pusan city during 1991~1995 was similar to that of previous report during 1981~1990, while the proportion of ALL had tendency to increase up to that of United States, in contrast to the low proportions of ALL in the previous reports.
Assuntos
Feminino , Humanos , Masculino , Exame de Medula Óssea , Hospitais Gerais , Hospitais Universitários , Incidência , Coreia (Geográfico) , Leucemia , Mortalidade , Estados UnidosRESUMO
Clinical observations were made on 338 low birth weight infants, who were delivered at Pusan Wallace Memorial Baptist Hospital, during the 3 year periods from 1989 to 1991. The results were as follows; The incidence of LBWI was 5.6% and sex ratio was 1:1.09. Among them AGA was 62.7%. 2) Of all infants, 47.3% were in the birth weight range of 2251-2500 gm and 25.1% were in the gestational age group of 37-38 week. 3) LBWI were most prevalent among mothers under 20 years old and over 41 years old. 4) The Incidence of LBWI was higher in multiparity than primiparity and in multiple pregnancy than single pregnancy. 5) Vaginal delivery was 63.9% and c-section delivery was 36.1%. 6) The order or frequency of the etiology of LBWI was multiple pregnancy, premature rupture of membrane and toxemia. 7) The mortality rate of LBWI was 12.7% and mortality rate by weight-gestational age was lower in AGA group than SGA and LGA group. 8) A Higher mortality rate was noted in the group of lower birth weight infant, and in the group of more shortened gestational age. 9) 48.8% of death occured within ist day of birth. The common causes of death were respiratory distress syndrome, asphyxia, and apnea.
Assuntos
Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Adulto Jovem , Apneia , Asfixia , Peso ao Nascer , Causas de Morte , Idade Gestacional , Incidência , Recém-Nascido de Baixo Peso , Membranas , Mortalidade , Mães , Paridade , Parto , Gravidez Múltipla , Protestantismo , Ruptura , Razão de Masculinidade , ToxemiaRESUMO
No abstract available.