We evaluated the clinical characteristics of acute myocarditis children, especially chief complaints on first visit at a hospital and prognosis. A retrospective descriptive study was conducted to identify patients with myocarditis who presented over a 10-year span at a regional tertiary hospital. Patients were identified based on the international classification of diseases 10, diagnostic codes. Total 18 patients were enrolled in the study. The patients had a median age of 16 months and 61% of them were male. Common chief complaints were shortness of breath, lethargy, cough or palpitation. Of the patients, 5 patients showed gastrointestinal symptoms such as vomiting, abdominal pain and loose stool as initial symptoms. Eighty nine percent of patients had cardiomegaly on chest x-ray, and 72% of patients had an abnormal electrocardiogram results. On first admission, 4 patients were died and 3 of them showed vomiting and abdominal pain as first chief complaints. These data suggest that abdominal pain and vomiting may be chief complaints of acute myocarditis. And myocarditis patients who showed gastrointestinal symptoms initially had poor prognosis. In addition, to distinguish an acute myocarditis, cardiomegaly on chest x-ray and an abnormal electrocardiogram may be useful.
Abdominal Pain ; Cardiomegaly ; Child* ; Cough ; Dyspnea ; Electrocardiography ; Humans ; International Classification of Diseases ; Lethargy ; Male ; Myocarditis* ; Prognosis* ; Retrospective Studies ; Shock ; Tertiary Care Centers ; Thorax ; Vomiting

An apparent life-threatening event (ALTE) is defined as the combination of clinical presentations such as apnea, marked change in skin and muscle tone, gagging, or choking. It is a frightening event, and it predominantly occurs during infancy at a mean age of 1–3 months. The causes of ALTE are categorized into problems that are: gastrointestinal (50%), neurological (30%), respiratory (20%), cardiovascular (5%), metabolic and endocrine (2%–5%), or others such as child abuse. Up to 50% of ALTEs are idiopathic, where the cause cannot be diagnosed. Infants with an ALTE are often asymptomatic at hospital and there is no standard workup protocol for ALTE. Therefore, a detailed initial history and physical examination are important to determine the extent of the medical evaluation and treatment. Regardless of the cause of an ALTE, all infants with an ALTE should require hospitalization and continuous cardiorespiratory monitoring and evaluation for at least 24 hours. The natural course of ALTEs has seemed benign, and the outcome is generally associated with the affected infants' underlying disease. In conclusion, systemic diagnostic evaluation and adequate treatment increases the survival and quality of life for most affected infants.
Airway Obstruction ; Apnea ; Child ; Child Abuse ; Gagging ; Hospitalization ; Humans ; Infant ; Infantile Apparent Life-Threatening Event ; Physical Examination ; Quality of Life ; Skin

No abstract available.
Gestational Age* ; Mortality

We investigated the clinical presentations, diagnostic and therapeutic modalities, and prognosis from follow-up of infants with apparent life-threatening events (ALTE). In addition, the relationship between the clinical characteristics of patients and significant intervention scores was analyzed. We enrolled patients younger than 12 months who were diagnosed with ALTE from January 2005 to December 2012. There were 29 ALTE infants with a peak incidence of age younger than 1 month (48.3%). The most common symptoms for ALTE diagnosis were apnea (69.0%) and color change (58.6%). Eleven patients appeared normal upon arrival at hospital but 2 patients required cardiopulmonary resuscitation during the initial ALTE. The most common ALTE cause was respiratory disease, including respiratory infection and upper airway anomalies (44.8%). There were 20 cases of repeat ALTE and 2 cases of death during hospitalization. Four patients (15.4%) experienced recurrence of ALTE after discharge and 4 patients (15.4%) showed developmental abnormalities during the follow-up period. The patients with ALTE during sleep had lower significant intervention scores (P=0.015) compared to patients with ALTE during wakefulness and patients with previous respiratory symptoms had higher significant intervention scores (P=0.013) than those without previous respiratory symptoms. Although not statistically significant, there was a weak positive correlation between the patient's total ALTE criteria and total significant intervention score (Fig. 2, r=0.330, P=0.080). We recommend that all ALTE infants undergo inpatient observation and evaluations with at least 24 hr of cardiorespiratory monitoring, and should follow up at least within a month after discharge.
Age Distribution ; Clinical Decision-Making ; Critical Care/*statistics & numerical data ; Critical Illness/*mortality/*therapy ; Female ; *Hospital Mortality ; Hospitalization/*statistics & numerical data ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Republic of Korea/epidemiology ; Risk Factors ; Sex Distribution ; Survival Rate ; Treatment Outcome

No abstract available.
Actinomycosis*

No abstract available.
Actinomycosis*

BACKGROUND: We evaluated early and late pulmonary hypertension (PH) in preterm infants and its relation with bronchopulmonary dysplasia (BPD). METHODS: Sixty-seven preterm infants < 30 weeks' gestation underwent echocardiography within 14 days after birth for early PH and over 28 days after birth for late PH. We measured tricuspid regurgitation (TR) peak velocity, pulse Doppler-derived myocardial performance index (MPI) of right ventricle (RV) (RV MPI), eccentricity index (EI), and tricuspid annular plane systolic excursion (TAPSE). RESULTS: The median gestation age of patients was 27 weeks (range, 23–30 weeks) and median birth weight was 1030 g (range, 450–1780 g). TR peak velocity was measured only in 19 patients (28.4%). Patients with symptomatic early PH (n = 11) showed a significantly lower systolic EI and a significantly higher incidence of RV MPI > 0.38 and TAPSE < 0.5 cm than patients without PH. The incidence of symptomatic early PH was highest in severe BPD, although this was not statistically significant. Early echocardiographic parameters are not associated with BPD development. Patients with severe BPD showed a significantly higher RV MPI and a significantly higher incidence of RV MPI > 0.38 than patients with mild BPD, and a significantly lower systolic EI and a significantly higher incidence of systolic EI < 0.81 than patients without BPD. CONCLUSION: Systolic EI, RV MPI, and TAPSE were well represented symptomatic early PH, while systolic EI and RV MPI could be useful parameters for identifying late PH in preterm infants with BPD, even if they did not present PH symptoms.
Birth Weight ; Bronchopulmonary Dysplasia* ; Echocardiography* ; Heart Ventricles ; Humans ; Hydrogen-Ion Concentration ; Hypertension, Pulmonary* ; Incidence ; Infant, Newborn ; Infant, Premature* ; Parturition ; Pregnancy ; Premature Birth ; Tricuspid Valve Insufficiency

Heart murmurs are common in children. Most of them are innocent murmurs with normal heart anatomy and function, and only a few are pathologic murmurs with congenital heart anomaly or abnormal heart function. However, a heart murmur may be the sole symptom of serious heart disease. Therefore, careful evaluation of heart murmurs for distinguishing pathologic murmurs from innocent murmurs is important. Heart murmurs are described by their intensity, timing in the cardiac cycle, location, transmission, and quality. Murmurs, such as a holosystolic or diastolic murmur, of grade 3 or higher intensity, harsh quality, an abnormal S2, a systolic click, or increased intensity when the patient stands are more likely to be pathologic murmurs. Innocent murmurs are more likely to be systolic murmurs, with soft sounds, short duration, low pitch, and varying intensity with phases of respiration and posture (disappears with standing). Not only auscultation but also physical examination findings are important to evaluate heart murmurs. The gold standard test for the evaluation of any potentially pathologic murmur is echocardiography. For the appropriate use of echocardiography, close physical examination, including auscultation, is essential and requires considerable practice.

No abstract available.
Child ; Coronary Vessels ; Dilatation ; Humans

PURPOSE: The objective of this study was to determine the effects of self-efficacy and depression on the sense of family coherence in both cancer patients and their caregivers using the Actor-Partner Interdependence Model (APIM) analysis.METHODS: A total of 274 patients were registered in the study, including 137 cancer patients who were undergoing chemotherapy in a day care ward and 137 primary caregivers. The data was collected from December 30, 2017 to July 30, 2018. Data were analyzed by the data analysis method using SPSS/WIN 20.0 (SPSS Korea Data Solution Inc) and AMOS 21.0 (SPSS Korea Data Solution Inc).RESULTS: Self-efficacy of cancer patients had a direct effect on patient depression (β=−.24, p=.008). Self-efficacy of primary caregivers also had a direct effect on patient depression (β=−.51, p < .001). Factors significantly affecting cancer patient FSOC were cancer patient self-efficacy (β=.34, p < .001) and cancer patient depression (β=−.42, p < .001). Factors significantly affecting primary caregiver FSOC (Family Sense of Coherence) were cancer patient self-efficacy (β=.13, p=.026) and caregiver depression (β=−.29, p=.008).CONCLUSION: It is thought that self-efficacy and depression should be controlled to improve the family cohesion of cancer patients and their primary caregivers.
Caregivers ; Day Care, Medical ; Depression ; Drug Therapy ; Humans ; Korea ; Methods ; Sense of Coherence ; Statistics as Topic