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Breastfeeding-associated neonatal hypernatremic dehydration in a medical center: a clinical investigation. 某医疗中心母乳喂养相关新生儿高钠血症性脱水的临床研究
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0186
Ann-Ching Wang, Shyi-Jou Chen, Y. Yuh, Y. Hua, T. Lu, Chuen-Ming Lee
BACKGROUNDHypernatremic dehydration amongst exclusively breastfed neonates due to inadequate breastfeeding or underfeeding is a potentially devastating condition. We investigated the epidemiological and clinic features of hypernatremic dehydration.METHODSWe retrospectively reviewed the medical records of neonates that were less than 28 days of age, weighing > or =2000 g with gestational age of 36 weeks born between January 2002 and December 2005, who had meet the criteria of hypernatremic dehydration, including (1) exclusively breastfed; (2) loss of weight 12% or more from birth weight; and (3) serum sodium concentration of at least 150 mmol/L at presentation, that had been subsequently admitted to our institution.RESULTSTotally nine cases were found during this four-year period, an incidence of 2.3 per 1000 live births. Involved infants' age at presentation ranged from 3 days to 14 days (mean t Standard Deviation = 7 +/- [3.8]); five presented symptoms or signs within the first week of life. Study-involved infants featured a birth-weight loss ranging from 12% to 29% (mean +/- [SD] = 17.0 +/- [5.9]), and also hypernatremia (mean +/- [SD] = 153.5 +/- [3.2] mEq/L ). Sodium concentration of breast milk ranged from 15 mEq/L to 54 mEq/L (mean +/- [SD]= 36.0 +/- [14.32]). Subsequently, all were supplemented with breast milk or, alternatively, formula. None of the study-involved neonates suffered subsequent complications or a relapse of their condition.CONCLUSIONSNeonatal hypernatremic dehydration due to inadequate breastfeeding or underfeeding would appear to be a rather common problem. In order to avoid serious morbidity and mortality, all breastfed infants should receive regular follow-up by health-care worker. Furthermore, we advocate that all mothers should be taught the skills of breastfeeding, and warning signs of breastfeeding failure and hypernatremia, accompanied with the monitoring of the weight of infants until growth commences, in order to reduce the likelihood of this condition arising, especially for first-time mothers.
背景:在纯母乳喂养的新生儿中,由于母乳喂养不足或喂养不足导致的高钠血症性脱水是一种潜在的破坏性疾病。我们调查了高钠血症性脱水的流行病学和临床特点。方法回顾性分析2002年1月~ 2005年12月出生的符合高钠血症性脱水标准的出生日龄小于28天、体重为bb0或=2000 g、胎龄为36周的新生儿的医疗记录,包括:(1)纯母乳喂养;(2)体重比出生体重减少12%以上;(3)入院时血清钠浓度至少为150 mmol/L。结果4年期间共发现9例,发病率为2.3 / 1000。患儿出生时的年龄从3天到14天不等(平均标准差= 7 +/- [3.8]);其中5人在出生后的第一周内出现症状或体征。参与研究的婴儿的出生体重下降范围为12%至29%(平均+/- [SD] = 17.0 +/-[5.9]),还有高钠血症(平均+/- [SD] = 153.5 +/- [3.2] mEq/L)。母乳钠浓度为15 ~ 54 mEq/L(平均值+/- [SD]= 36.0 +/-[14.32])。随后,所有人都补充母乳或配方奶粉。所有参与研究的新生儿都没有出现并发症或病情复发。结论母乳喂养不足或喂养不足引起的新生儿高钠血症性脱水是一个较为普遍的问题。为了避免严重的发病率和死亡率,所有母乳喂养的婴儿都应接受保健工作者的定期随访。此外,我们主张,所有母亲都应该学习母乳喂养的技巧,以及母乳喂养失败和高钠血症的警告信号,同时监测婴儿的体重,直到开始生长,以减少出现这种情况的可能性,特别是对第一次母亲。
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引用次数: 12
Central core disease with family history of malignant hyperthermia: report of one case. 有恶性高热家族史的中央核心病1例报告。
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0217
Inn-Chi Lee, Yung-Jung Chen, Peng-Cheng Fang
A 10-month-old boy presented with gross motor delay and muscle weakness, especially in both lower limbs. At age 5, he developed lordosis, talipes, and planovalgus. His grandmother died of malignant hyperthermia during surgery. On neurological examination, he had mild proximal muscle weakness and atrophy, decreased deep tendon reflexes and Gowers' sign, but his intelligence was normal. The electromyogram showed myopathic pattern. Muscle biopsy revealed type 1 fiber atrophy and central core abnormalities. We report this case of central core disease with a family history of malignant hyperthermia during surgery.
一个10个月大的男孩表现为大运动迟缓和肌肉无力,特别是在两个下肢。5岁时,他出现前凸、拇趾和平外翻。他的祖母在手术中死于恶性高热。神经学检查,患者有轻度近端肌无力和萎缩,深肌腱反射减少和高尔斯征,但智力正常。肌电图显示肌病型。肌肉活检显示1型纤维萎缩和中央核心异常。我们报告这个病例的中央核心疾病与恶性高热的家族史在手术期间。
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引用次数: 1
Effects of a classroom-based weight-control intervention on cardiovascular disease in elementary-school obese children. 以课堂为基础的体重控制干预对小学肥胖儿童心血管疾病的影响
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0201
Shih‐Hui Huang, K. Weng, K. Hsieh, S. Ou, Chu‐Chuan Lin, K. Chien, Po-Yen Liu, Tsyr-Yuh Ho
BACKGROUNDChildhood obesity has become a growing public health issue in Taiwan. Obese children have risk factors for type 2 diabetes and cardiovascular disease. In this prospective study, we investigated the effect of a twelve-week heart health education and physical activity program on body weight and risk factors for type 2 diabetes and cardiovascular disease.METHODSSubjects were 120 obese fifth graders (65 boys and 55 girls, aged 10-13 years (mean 10.6 yrs), body mass index (BMI) at the 95th percentile or more) and were randomly assigned to an intervention group (n=60) or control group (n=60). The intervention group received a twelve-week heart health education and physical activity program, while the control group did not. In both groups, a series of examinations were done at baseline and post-test, including height, weight, BMI, body fat, blood pressure (BP), physical fitness (800-meter running test), heart health knowledge, and serum biochemistry. Differences for baseline and post-test data were compared between both groups.RESULTSMean changes in the intervention group versus control group were significant for weight (P = 0.024), BMI (P = 0.047), percentage body fat (P = 0.008), physical fitness (800-meter running test) (P = 0.025), heart health knowledge (P = 0.006), total cholesterol (P = 0.027), triglycerides (P = 0.018), high-density lipoprotein cholesterol (HDL-C) (P = 0.009), low-density lipoprotein cholesterol (LDL-C) (P = 0.041), sugar (P = 0.035), insulin (P = 0.007), and insulin resistance (HOMA-IR) (P = 0.028). At post-test, weight, BMI, body fat, total cholesterol, triglycerides, LDL-C, sugar, insulin and HOMA-IR had decreased, but HDL-C had increased in the intervention group.CONCLUSIONSA classroom-based weight-control intervention provides educational programs to promote cardiovascular health in children. This intervention is simple, practical, and beneficial for elementary school children.
背景儿童肥胖已成为台湾日益严重的公共健康问题。肥胖儿童有患2型糖尿病和心血管疾病的危险因素。在这项前瞻性研究中,我们调查了为期12周的心脏健康教育和体育活动计划对体重和2型糖尿病和心血管疾病危险因素的影响。方法选取体重指数(BMI)在第95百分位及以上的10 ~ 13岁(平均10.6岁)肥胖五年级学生120名(男65名,女55名),随机分为干预组(n=60)和对照组(n=60)。干预组接受了为期12周的心脏健康教育和体育活动计划,而对照组则没有。两组均在基线和测试后进行一系列检查,包括身高、体重、BMI、体脂、血压(BP)、体能(800米跑步试验)、心脏健康知识和血清生化。比较两组基线和测试后数据的差异。结果干预组与对照组在体重(P = 0.024)、BMI (P = 0.047)、体脂率(P = 0.008)、体能(800米跑试验)(P = 0.025)、心脏健康知识(P = 0.006)、总胆固醇(P = 0.027)、甘油三酯(P = 0.018)、高密度脂蛋白胆固醇(P = 0.009)、低密度脂蛋白胆固醇(P = 0.041)、糖(P = 0.035)、胰岛素(P = 0.007)、胰岛素抵抗(HOMA-IR) (P = 0.028)。测试后,干预组的体重、BMI、体脂、总胆固醇、甘油三酯、LDL-C、糖、胰岛素和HOMA-IR下降,但HDL-C升高。结论以课堂为基础的体重控制干预为促进儿童心血管健康提供了教育方案。这种干预方法简单实用,对小学生有益。
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引用次数: 34
Primary endocardial fibroelastosis with dilated cardiomyopathy: report of one case. 原发性心内膜纤维弹性增生合并扩张型心肌病1例报告。
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0213
Yen-Ting Chou, Jou-Kou Wang, H. Chou
We report a case of dilated cardiomyopathy presented in a premature infant of 27 weeks' gestational age. A prenatal sonography revealed left ventricular enlargement. The infant presented with respiratory distress and heart failure soon after birth. Echocardiograms performed after birth showed dilated cardiomyopathy, and endocardial fibroelastosis was suspected. Heart failure progressed despite administration of inotropic agents. The infant died after fifteen days from circulatory failure. Postmortem examination confirmed the diagnosis of endocardial fibroelastosis.
我们报告一例扩张性心肌病提出了一个早产儿27周孕龄。产前超声检查显示左心室增大。婴儿出生后不久就出现呼吸窘迫和心力衰竭。出生后进行的超声心动图显示扩张性心肌病,心内膜纤维弹性增生怀疑。尽管服用了肌力药物,心衰仍有进展。这名婴儿15天后死于循环衰竭。尸检确诊为心内膜纤维弹性增生。
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引用次数: 2
Guidelines for the management of community-acquired pneumonia in children. 儿童社区获得性肺炎管理指南。
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0167
P.-I. Lee, C. Chiu, Po‐Yen Chen, Chin‐Yun Lee, Tzou-Yien Lin
A. The prevalent pathogen is different in different agegroups.B. Atypical pneumonia1.Viral infections prevail in children younger than5 years of age, especially respiratory syncytialvirus. Other viral etiologies include influenzavirus, parainfluenza virus, adenovirus, humanmetapneumovirus, rhinovirus, and cytomegalovirus.2.
A.流行的病原体在不同的年龄组是不同的。非典型pneumonia1。病毒感染常见于5岁以下儿童,尤其是呼吸道合胞病毒。其他病毒病因包括流感病毒、副流感病毒、腺病毒、人偏肺病毒、鼻病毒和巨细胞病毒。
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引用次数: 38
Gamma-glutamyl transferase in the diagnosis of biliary atresia. γ -谷氨酰转移酶在胆道闭锁诊断中的应用。
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0196
Kuo-Shu Tang, Li-Tung Huang, Ying-Hsien Huang, Chi-Yin Lai, Chi-Hung Wu, Sheng-ming Wang, K. Hwang, F. Huang, M. Tiao
BACKGROUNDEarly diagnosis of biliary atresia (BA) is important because the prognosis is closely related to timing of Kasai operation. The aim of this study was to test the clinical application of serum gamma-glutamyl transferase (GGT) concentration and the ratio of serum GGT to aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in differentiating BA from neonatal hepatitis (NH).METHODSNinety-three (46 male and 47 female) cases of BA and 65 (45 male and 20 female) NH were included in this study. Serum concentrations of GGT, AST, and ALT were measured in all cholestatic infants. The results of peak GGT level, GGT/AST ratio, GGT/ALT ratio were compared between groups.RESULTSThe serum GGT levels were significantly higher in BA patients than those in NH patients (353.3 +/- 334.4 IU/L vs. 114.8 +/- 86 IU/L, P < 0.001). GGT/AST values were over 2 in 55/68 BA and 15/ 54 NH (OR = 11.0, 95% CI 4.7-25.7, P < 0.001). GGT/ALT values were over 2 in 54/65 BA and 19/50, NH respectively (OR = 8.0, 95% CI 3.4-19.0, P < 0.001). A GGT level greater than 300 IU/L had a sensitivity of 39.7% in the diagnosis of BA, GGT/AST over 2 was 80.9% and GGT/ALT over 2 was 83.1%; the specificities were 98.1%, 72.2% and 62.0%, respectively. The respective accuracies of the diagnosis of BA were 65.6%, 77.1% and 73.9%.CONCLUSIONSGGT/AST ratio over 2 indicates high possibility of biliary atresia and should prompt further investigations to confirm the diagnosis.
背景胆道闭锁(BA)的临床诊断非常重要,因为其预后与开赛手术的时机密切相关。本研究旨在探讨血清γ -谷氨酰转移酶(GGT)浓度及其与天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)比值在新生儿肝炎(NH)与BA鉴别中的临床应用价值。方法本研究共收集BA患者93例(男46例,女47例),NH患者65例(男45例,女20例)。测定所有胆汁淤积症患儿血清中GGT、AST和ALT的浓度。比较两组间GGT峰值水平、GGT/AST比值、GGT/ALT比值。结果BA患者血清GGT水平显著高于NH患者(353.3 +/- 334.4 IU/L vs 114.8 +/- 86 IU/L, P < 0.001)。55/68 BA和15/ 54 NH组GGT/AST值均大于2 (OR = 11.0, 95% CI 4.7 ~ 25.7, P < 0.001)。54/65 BA和19/50,NH组GGT/ALT值分别大于2 (OR = 8.0, 95% CI 3.4 ~ 19.0, P < 0.001)。GGT≥300 IU/L诊断BA的敏感性为39.7%,GGT/AST > 2的敏感性为80.9%,GGT/ALT > 2的敏感性为83.1%;特异性分别为98.1%、72.2%和62.0%。BA的诊断准确率分别为65.6%、77.1%和73.9%。结论sggt /AST比值大于2提示胆道闭锁可能性高,应进一步检查以明确诊断。
{"title":"Gamma-glutamyl transferase in the diagnosis of biliary atresia.","authors":"Kuo-Shu Tang, Li-Tung Huang, Ying-Hsien Huang, Chi-Yin Lai, Chi-Hung Wu, Sheng-ming Wang, K. Hwang, F. Huang, M. Tiao","doi":"10.7097/APT.200708.0196","DOIUrl":"https://doi.org/10.7097/APT.200708.0196","url":null,"abstract":"BACKGROUND\u0000Early diagnosis of biliary atresia (BA) is important because the prognosis is closely related to timing of Kasai operation. The aim of this study was to test the clinical application of serum gamma-glutamyl transferase (GGT) concentration and the ratio of serum GGT to aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in differentiating BA from neonatal hepatitis (NH).\u0000\u0000\u0000METHODS\u0000Ninety-three (46 male and 47 female) cases of BA and 65 (45 male and 20 female) NH were included in this study. Serum concentrations of GGT, AST, and ALT were measured in all cholestatic infants. The results of peak GGT level, GGT/AST ratio, GGT/ALT ratio were compared between groups.\u0000\u0000\u0000RESULTS\u0000The serum GGT levels were significantly higher in BA patients than those in NH patients (353.3 +/- 334.4 IU/L vs. 114.8 +/- 86 IU/L, P < 0.001). GGT/AST values were over 2 in 55/68 BA and 15/ 54 NH (OR = 11.0, 95% CI 4.7-25.7, P < 0.001). GGT/ALT values were over 2 in 54/65 BA and 19/50, NH respectively (OR = 8.0, 95% CI 3.4-19.0, P < 0.001). A GGT level greater than 300 IU/L had a sensitivity of 39.7% in the diagnosis of BA, GGT/AST over 2 was 80.9% and GGT/ALT over 2 was 83.1%; the specificities were 98.1%, 72.2% and 62.0%, respectively. The respective accuracies of the diagnosis of BA were 65.6%, 77.1% and 73.9%.\u0000\u0000\u0000CONCLUSIONS\u0000GGT/AST ratio over 2 indicates high possibility of biliary atresia and should prompt further investigations to confirm the diagnosis.","PeriodicalId":7156,"journal":{"name":"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82801940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 35
Congenital lobar emphysema mimicking cystic mass in a newborn. 新生儿先天性肺气肿样囊性肿块。
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0220
Yu-Chen Lin, Yu-Kang Chang, D. Lu, T. Shih
Congenital lobar emphysema (CLE) is thought to be a result of obstruction of the bronchus which causes air-trapping and overinflation of lung segments or lobes. It usually presents as a hyperlucent region on chest radiography. However, if there is accompanying retention of lung fluid, the affected region becomes opaque. Of such a lesion, the computed tomography (CT) scans or ultrasonographic findings have been rarely mentioned in the literature. We report the CT and echographic findings of CLE with retained lung fluid in a newborn. The lesion presented as a cystic mass on CT; ultrasonographic examination demonstrated its real solid contexture.
先天性大叶性肺气肿(CLE)被认为是支气管阻塞的结果,支气管阻塞导致肺段或肺叶的空气潴留和过度膨胀。通常在胸片上表现为高光区。然而,如果伴有肺积液,则受影响的区域变得不透明。对于此类病变,计算机断层扫描(CT)或超声检查结果在文献中很少提及。我们报告一位新生儿的CLE伴肺积液的CT和超声检查结果。CT表现为囊性肿块;超声检查显示其真实的实性结构。
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引用次数: 2
Breastfeeding-associated hypernatremic dehydration. 母乳喂养引起的高钠血症性脱水。
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0165
Chyong-hsin Hsu
{"title":"Breastfeeding-associated hypernatremic dehydration.","authors":"Chyong-hsin Hsu","doi":"10.7097/APT.200708.0165","DOIUrl":"https://doi.org/10.7097/APT.200708.0165","url":null,"abstract":"","PeriodicalId":7156,"journal":{"name":"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75818110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Using the child behavior checklist to evaluate behavioral problems in children with epilepsy. 应用儿童行为检查表评估癫痫患儿的行为问题。
Pub Date : 2007-08-01 DOI: 10.7097/APT.200708.0181
Peng-Cheng Fang, Yung-Jung Chen
BACKGROUNDChildhood epilepsy is commonly associated with behavioral problems. In this study, we used the Child Behavior Checklist (CBCL) to determine a behavioral profile for children with chronic epilepsy.METHODSFifty-six children with epilepsy and 45 aged-matched healthy controls were evaluated by analyzing the clinical variables of all study participants. Scores of the CBCL were markedly higher in patients than those in healthy controls for both internalizing and externalizing behaviors, which consisted of subscales of aggressive behavior, anxiety/depression, attention problems, thought problems, withdrawal, and somatic complaints.RESULTSWe found behavioral disturbances in 42% (n=24) of the epileptic patients and in 8% (n=4) of the controls. No significant differences were found between patients with and without behavioral problems on the clinical variables.CONCLUSIONSBehavioral problems deserve special attention in children with epilepsy. CBCL can be used as a screening instrument with these children.
背景:儿童癫痫通常与行为问题有关。在这项研究中,我们使用儿童行为检查表(CBCL)来确定慢性癫痫儿童的行为特征。方法对56例癫痫患儿和45例年龄匹配的健康对照进行临床变量分析。包括攻击性行为、焦虑/抑郁、注意力问题、思维问题、退缩和躯体抱怨在内的内化和外化行为量表,患者的CBCL得分均显著高于健康对照组。结果42%的癫痫患者(n=24)和8%的对照组(n=4)存在行为障碍。行为问题患者与无行为问题患者在临床变量上无显著差异。结论癫痫患儿的行为问题值得重视。CBCL可作为这些儿童的筛查工具。
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引用次数: 10
Breastfeeding-associated hypernatremic dehydration. 母乳喂养引起的高钠血症性脱水。
Chyong-Hsin Hsu
{"title":"Breastfeeding-associated hypernatremic dehydration.","authors":"Chyong-Hsin Hsu","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7156,"journal":{"name":"Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2007-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27256274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Acta paediatrica Taiwanica = Taiwan er ke yi xue hui za zhi
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