ABSTRACT
By September 2022, approximately 2. 88 million doses of COVID-19 mRNA vaccine had been administered in Japanese children, and 9 cases of vaccine-related anaphylaxis had been reported. Of these, 2 cases were determined to be definite anaphylaxis by expert review, for an incidence rate of 0. 7 cases per million doses. This is equivalent to the incidence of anaphylaxis from adverse reactions to existing vaccines. If anaphylaxis occurs, pediatricians should administer an intramuscular injection of adrenaline, the first choice of treatment for anaphylaxis. The allergen contained in mRNA vaccines is likely to be polyethylene glycolPEG. Therefore, we must be cau-tious in our decision to vaccinate individuals with a history of allergic reactions to PEG-containing agents. However, since no clinical test has been established to confirm allergic reactions to PEG prior to vaccination, efforts are being made to identify high-risk patients by questionnaire. It is necessary for each facility to clearly state how to respond to anaphylaxis and share information among staff so that treatment can be reliably administered in the event of anaphylaxis.Copyright © 2022, Dokkyo University School of Medicine. All rights reserved.
ABSTRACT
By September 2022, approximately 2. 88 million doses of COVID-19 mRNA vaccine had been administered in Japanese children, and 9 cases of vaccine-related anaphylaxis had been reported. Of these, 2 cases were determined to be definite anaphylaxis by expert review, for an incidence rate of 0. 7 cases per million doses. This is equivalent to the incidence of anaphylaxis from adverse reactions to existing vaccines. If anaphylaxis occurs, pediatricians should administer an intramuscular injection of adrenaline, the first choice of treatment for anaphylaxis. The allergen contained in mRNA vaccines is likely to be polyethylene glycol(PEG). Therefore, we must be cau-tious in our decision to vaccinate individuals with a history of allergic reactions to PEG-containing agents. However, since no clinical test has been established to confirm allergic reactions to PEG prior to vaccination, efforts are being made to identify high-risk patients by questionnaire. It is necessary for each facility to clearly state how to respond to anaphylaxis and share information among staff so that treatment can be reliably administered in the event of anaphylaxis.Copyright © 2022, Dokkyo University School of Medicine. All rights reserved.
ABSTRACT
By September 2022, approximately 2. 88 million doses of COVID-19 mRNA vaccine had been administered in Japanese children, and 9 cases of vaccine-related anaphylaxis had been reported. Of these, 2 cases were determined to be definite anaphylaxis by expert review, for an incidence rate of 0. 7 cases per million doses. This is equivalent to the incidence of anaphylaxis from adverse reactions to existing vaccines. If anaphylaxis occurs, pediatricians should administer an intramuscular injection of adrenaline, the first choice of treatment for anaphylaxis. The allergen contained in mRNA vaccines is likely to be polyethylene glycol(PEG). Therefore, we must be cau-tious in our decision to vaccinate individuals with a history of allergic reactions to PEG-containing agents. However, since no clinical test has been established to confirm allergic reactions to PEG prior to vaccination, efforts are being made to identify high-risk patients by questionnaire. It is necessary for each facility to clearly state how to respond to anaphylaxis and share information among staff so that treatment can be reliably administered in the event of anaphylaxis.Copyright © 2022, Dokkyo University School of Medicine. All rights reserved.
ABSTRACT
With the global outbreak of coronaviruses, children are spending more time in the home. As a result, the number of accidents in which children swallow foreign objects has been increasing. When a child swallows a foreign body, the pediatrician performs an x-ray to check for the presence of a foreign body in the body. We investigated X-rays of items that are frequently swallowed by children. In this study, radiographic permeability was confirmed for 43 types of items that are at high risk for aspiration and accidental ingestion by children. According to permeability, the items were classified into three groups: Radio graphically legible, illegible, and illegible. The limitation of this study is that it is an x-ray image of an object only. Therefore, the x-ray images do not match those of an object swallowed by a child's body. In some cases, endoscopic or laparotomy surgery is required to remove the foreign object. There have also been deaths caused by foreign objects. To prevent sad accidents, the primary prevention is to avoid placing small objects near infants. Copyright © 2022, Dokkyo University School of Medicine. All rights reserved.
ABSTRACT
We report that the management for children with severe motor and intellectual disabilities who required medical care in a specialized ward for control the COVID19 infection. The early stage of the infection could be managed as at outpatient department. On the 8th day, she suffered from respiratory failure. Chest CT showed infiltration shadows in both lungs. Then, she was diagnosed with acute lung injury. She and her mother were admitted to a specialized ward for coronavirus infection. She was successfully treated with remdesivir and dexamethasone, with mechanical ventilation. And she was discharged on the 17th day from the admission. For managing her severe pneumonia in special hospital environment for COVID-19, the medical staff considered how to manage the time of medical care and medical supplies. As a result, we archived attention to preventive infection control and minimizing visits and care times. In the management of the COVID-19 infection in children with neurological sequelae, which requiring medical care, family cooperation and hospital room adaptations are important. Copyright © 2022, Dokkyo University School of Medicine. All rights reserved.
ABSTRACT
Since the spring of 2020, a state of emergency has been declared due to the spread of the COVID-19 epidemic. Many patients visited the pediatric outpatient department due to social anxiety and indefinite complaints. Many patients have a temporary psychogenic reaction associated with anxiety. However, clinically, it is important to distin-guish it from orthostatic dysregulationOD. At our hospital, we are conducting a Schellong test using an electrocardiogram and an blood pressure monitor to diagnose OD. We retrospectively diagnosed OD and classified subtypes based on medical records of patients who visited our hospital with indefinite complaints and underwent the Schel-long test. The survey period was 13 months from January 2020 to the end of January 2021, and a total of 42 Schel-long tests were conducted on 40 patients. The mean age of the patients was 13.1 years, 22 boys and 18 girls, with a mean BMI of 19.1. The tests were performed in 29 cases in the morning and 11 cases in the afternoon. The main complaints based on the physical symptom items of the Pediatric Orthostatic Regulation Diagnosis and Treatment Guideline 2015 were headache in 23 cases, dizziness in 12 cases, late morning or absenteeism in 11cases, and diges-tive symptom in 10 cases. Loss of consciousness was observed in 13 cases. The Schellong test was positive in 36 of 40 cases. Postural tachycardia syndromePOTS accounted for 23 cases of OD subtype in Schellong test positive subjects. The severity was severe in 13 cases. In children with indefinite complaints, it is important to con-duct the Shellong test with the possibility of POTS in mind.