OBJECTIVE: To explore the correlation of temperament type and mother's emotional state with acute respiratory tract infections in children so as to provide evidence for comprehensive treatment of the infections. METHODS: A total of 200 children aged between 3 and 6 were enrolled in this study from two kindergartens of Guangzhou and Hengyang. The mothers were invited to complete a questionnaire of the children's general information followed by assessment using children's temperament scale and the Depression-Anxiety-Stress Scale. RESULTS: The total incidence of acute respiratory infection was significantly higher in children with a hard- to-raise temperament than the easy- to-raise children (P < 0.05); the incidences of acute rhinitis, acute pharyngitis, acute laryngitis and acute bronchitis were all significantly higher in the hard-to-raise children (P < 0.05). A significant positive correlation was identified between the total number of episodes of acute respiratory tract infection in children and their mothers' stress and anxiety levels (P < 0.01). Acute rhinitis and acute tracheitis in the children were both positively correlated with the mothers' stress scores (P < 0.05), while acute pharyngitis and acute laryngitis were positively correlated with the mothers' anxiety scores (P < 0.05), while acute bronchitis was positively correlated with the mothers' stress and anxiety scores (P < 0.05). Multiple linear regression analysis with the factors influencing the types of acute respiratory tract infections in children as the independent variables suggested that the easy-to-raise type of temperament was a protective factor against acute rhinitis in children (P < 0.05), while mothers' anxiety was a risk factor of acute laryngitis in children (P < 0.05); the mothers' stress was a risk factor for acute bronchitis in children (P < 0.05). CONCLUSION Acute respiratory tract infection in children is closely related to the temperament type of the children and the emotional state of the mothers, which are important therapeutic targets in comprehensive interventions of acute respiratory tract infection in children.
Bronchitis ; Child ; Child, Preschool ; Female ; Humans ; Laryngitis ; Mothers/psychology* ; Pharyngitis ; Rhinitis ; Temperament

Objectives: The purpose of this study was to determine the efficacy of proton pump inhibitor (PPI) therapy in treating the symptoms and laryngeal findings of laryngopharyngeal reflux (LPR). Methods: Placebo-controlled, randomized clinical trials published after June 2001 to January 2021 which used PPI as the sole intervention and the RSI or RFS as outcome measures were eligible for inclusion. Studies that were published prior to June 2001, those which only made use of questionnaires other than the RSI or RFS, those which used PPI in combination with other treatments, or those with unavailable full-text manuscripts were excluded. These studies were identified from MEDLINE, Scopus, Cochrane Library, Embase, and HERDIN Plus databases which were searched from May 21 to 26, 2020. The primary outcome was the mean difference between baseline/pre-treatment and post-treatment RSI scores for both PPI and placebo groups. The secondary outcome was the mean difference between pre-treatment and post-treatment RFS scores for PPI and placebo groups. Aggregate results of these outcomes were analyzed using forest plots. Heterogeneity was determined through prediction intervals. Risk of bias of individual studies was assessed using the Cochrane Collaboration’s Tool in Assessing Risk of Bias. Results: Nine randomized control trials were included with a total of 737 patients randomized and 595 patients analyzed – 294 from the PPI group and 301 from the placebo group. There were notable variations among the studies in terms of choice of PPI, dosage and frequency. Out of nine studies, four used both RSI and RFS in their analysis. Two studies used RSI alone and three used the RFS in combination with symptom questionnaires other than the RSI. There was a significant decrease in the RSI of the PPI group versus the placebo group with a mean difference of -2.83 (95% CI, -5.13 to -0.53, p = .02). However, there was no significant decrease in the RFS between PPI and placebo groups with a mean difference of -0.84 (95% CI, -2.66 to 0.98, p = .37). For two clinical trials which only reported post-treatment RFS, there was also no significant difference between the two treatment groups with a mean difference of 1.27 (95% CI, -0.22 to 2.76, p = .10). Conclusion This meta-analysis found that, although a statistically significant benefit in RSI was noted with PPI therapy, this difference may not translate to a clinically significant change in symptoms; therefore, there is insufficient evidence to recommend for or against the treatment of LPR with PPIs.
Laryngopharyngeal Reflux ; Proton Pump Inhibitors ; Laryngitis ; Hoarseness

Biomarkers, Tumor ; Child ; Humans ; Laryngitis ; Neoplasms, Muscle Tissue

A 46-year old man visited our outpatient clinic with complaint of foreign body sensation in throat after consuming raw freshwater fish 5 days ago. Laryngoscopic examination revealed a motile worm attached on posterior pharyngeal wall. The worm was removed using biopsy forceps under transnasal endoscopy and evidently identified as Clinostomum complanatum after microscopic examination. Patient’s subjective foreign body sensation of throat and hyperemia of laryngeal mucosa remained for approximately 2 weeks post-removal, which were eventually resolved after administration of non-steroidal anti-inflammatory drug and anti-refluxant drug for 2 weeks. Treatment was ended at three weeks since the first visit. C. complanatum infections in humans are rare, and only four cases have been reported in Korea. Symptoms resembling pharyngitis or laryngitis occurs by consumption of raw, infected freshwater fish and treatment is done by mechanically removing the parasite.
Ambulatory Care Facilities ; Biopsy ; Endoscopy ; Foreign Bodies ; Fresh Water ; Humans ; Hyperemia ; Korea ; Laryngeal Mucosa ; Laryngitis ; Parasites ; Pharyngitis ; Pharynx ; Sensation ; Surgical Instruments

PURPOSE: Croup is a common respiratory disease in children. The aim of this study was to analyze the epidemiology, etiology, and seasonal variations of respiratory virus infections in children with croup. METHODS: From October 2009 to September 2017, children admitted with croup to Gachon University Gil Medical Center under the age of 18 years were enrolled in this study. We retrospectively reviewed patients' medical records. RESULTS: A total of 1,053 of 27,330 patients (3.9%) infected with lower respiratory infections were diagnosed as having croup. In the age distribution, croup was most common (50.0%) in children aged 1 to <2 years. There were 2 peaks, the major in summer (July to August) and the minor in spring (March to May). Parainfluenza virus type 1 (15.8%) was most prevalent and coincided with the summer peaks of croup. Influenza virus type B and parainfluenza virus type 3 were the most frequent etiologic agents in a spring peak of croup. Although parainfluenza virus type 1 was predominant of all ages, human coronavirus was a significant cause of croup in children younger than 1 year, whereas influenza virus played an important role in children above the age of 3 years. CONCLUSION: Seasonality and epidemiology of croup varied with age and regions. Two peaks of seasonal fluctuation were in summer and spring, which were related to the seasonality of respiratory viruses in croup. These results may be helpful in planning clinical and research needs.
Age Distribution ; Child ; Coronavirus ; Croup* ; Epidemiology ; Humans ; Medical Records ; Orthomyxoviridae ; Parainfluenza Virus 1, Human ; Parainfluenza Virus 3, Human ; Respiratory System* ; Respiratory Tract Infections* ; Retrospective Studies ; Seasons*

PURPOSE: Croup is known to have epidemics in seasonal and biennial trends, and to be strongly associated with epidemics of parainfluenza virus. However, seasonal and annual epidemics of croup have not been clearly reported in Korea. This study aimed to examine the seasonal/annual patterns and etiologies of childhood croup in Korea during a consecutive 6-year period. METHODS: Pediatric croup data were collected from 23 centers in Korea from 1 January 2010 to 31 December 2015. Electronic medical records, including multiplex reverse transcription polymerase chain reaction (RT-PCR) results, demographics and clinical information were cross-sectionally reviewed and analyzed. RESULTS: Overall, 2,598 childhood croup patients requiring hospitalization were identified during the study period. Among them, a total of 927 who underwent RT-PCR were included in the analysis. Males (61.5%) predominated, and most (63.0%) of them were younger than 2 years of age (median, 19 months; interquartile range, 11–31 months). Peak hospitalization occurred in 2010 and 2012 in even-numbered years, and parainfluenza virus (PIV, 39.7%) was the most common cause of childhood croup requiring hospitalization, followed by respiratory syncytial virus (14.9%), human rhinovirus (12.5%), Mycoplasma pneumonaie (10.6%), and human coronavirus (7.3%). CONCLUSION: It is concluded that croup hospitalization has a biennial pattern in even-numbered years. PIV may be the most common cause of childhood croup; however, croup epidemics could be attributed to other viruses.
Child ; Coronavirus ; Croup ; Demography ; Electronic Health Records ; Hospitalization ; Humans ; Korea ; Male ; Mycoplasma ; Paramyxoviridae Infections ; Polymerase Chain Reaction ; Respiratory Syncytial Viruses ; Retrospective Studies ; Reverse Transcription ; Rhinovirus ; Seasons

No abstract available.
Child ; Croup ; Humans ; Korea

PURPOSE: In this study, the clinical and epidemiological characteristics of patients admitted for viral croup were analyzed to evaluate disease severity based on the organism that caused the infection. METHODS: We retrospectively reviewed the medical records of 302 patients who were admitted to the Department of Pediatrics at the Wonju Severance Hospital between May 2013 and December 2016 for viral croup. Patients who showed positive results on multiplex polymerase chain reaction were subsequently diagnosed with respiratory virus infection. The Westley scoring system was used to evaluate the severity of viral croup. RESULTS: Of the 302 patients, 149 were admitted due to severe viral croup, including 88 boys and 61 girls, with a boy-to-girl ratio of 1.44:1. About 110 cases of parainfluenza virus infection have been reported, which accounted for almost half of the total cases. The other identified viruses included influenza virus, human rhinovirus, and respiratory syncytial virus. Analysis of the association between severe viral croup and causative pathogen revealed that only parainfluenza type 2 virus showed a significantly high risk. Parainfluenza type 2 virus did not show an age-based difference in frequency but showed relatively a higher frequency of infections during the summer and fall. CONCLUSIONS: In this study, parainfluenza virus type 2 was the only virus associated with severe viral croup. To facilitate proper preventive management, treatment, and prognosis evaluation of viral croup, prospective and multicenter studies should assess the additional variables and the severity of the virus. Additionally, further studies should be conducted to assess age-dependent influences, as well as the regional and seasonal incidence of viral infection.
Child ; Child, Hospitalized ; Croup ; Epidemiology ; Female ; Gangwon-do ; Humans ; Incidence ; Medical Records ; Multiplex Polymerase Chain Reaction ; Orthomyxoviridae ; Parainfluenza Virus 2, Human ; Paramyxoviridae Infections ; Pediatrics ; Prognosis ; Prospective Studies ; Respiratory Syncytial Viruses ; Retrospective Studies ; Rhinovirus ; Seasons ; Severity of Illness Index

PURPOSE: We aimed to identify the epidemiology and the clinical characteristics of human parainfluenza virus type 4 (HPIV-4) infection compared to HPIVs 1–3 infections in Korean children. METHODS: We reviewed medical records of children with HPIV infection who visited Seoul National University Children's Hospital from 2015 to 2017. Detection of respiratory viruses was performed using real time-polymerase chain reaction (rt-PCR), which could differentiate HPIVs 1–4. Diagnosis was classified as a febrile illness, upper respiratory tract infection (URI), croup, bronchiolitis, or pneumonia. The epidemiology, demographic features, and clinical characteristics among HPIV types were compared. The clinical data were analyzed only for the previously healthy children. RESULTS: Of the 472 children diagnosed with HPIV infection, 108 (22.9%) were previously healthy: 24 (22.2%), 19 (17.6%), 39 (36.1%), and 26 (24.1%) in HPIV types 1, 2, 3, and 4, respectively. The median age of children with HPIV-4 infection was 11 (0–195) months: the proportion of children aged < 2 years and 2 to < 5 years were 65.4% and 19.2%, respectively. Clinical diagnoses of HPIV-4 infection were bronchiolitis (38.5%), pneumonia (30.8%), and URI (30.8%). Croup was the most prevalent in HPIV-2 (21.1%) and none in HPIV-4 infection (P=0.026). Hospital admission rates among HPIV types were not significantly different (P> 0.05). CONCLUSIONS: We observed seasonal peak of HPIV-4 infection in 2015 and 2017. HPIV-4 was a common respiratory pathogen causing lower respiratory tract infection in hospitalized children.
Bronchiolitis ; Child ; Child, Hospitalized ; Croup ; Diagnosis ; Epidemiology ; Humans ; Medical Records ; Parainfluenza Virus 4, Human ; Paramyxoviridae Infections ; Pneumonia ; Respiratory Tract Infections ; Seasons ; Seoul

PURPOSE: We evaluated the clinical features of croup in children according to viral etiology. METHODS: This study enrolled pediatric patients with croup, who showed positive results on respiratory virus reverse transcriptase polymerase chain reaction performed between January 2012 and December 2017. We retrospectively reviewed the medical records. RESULTS: A total of 179 patients (119 boys and 60 girls) were enrolled with the mean age of 18.9±14.7 months. The viruses commonly identified were parainfluenza, respiratory syncytial virus, rhinovirus, and influenza. Among these 4 viruses, patients with rhinovirus infection showed significantly shorter fever and admission durations. Patients with parainfluenza infection showed significantly lower incidences of epinephrine nebulization and patients with influenza infections showed significantly higher incidences of steroid treatment. CONCLUSION: Clinical manifestations of croup differ according to causative viruses. Further studies should be conducted to evaluate the severity and prognosis of croup according to viral etiology.
Child* ; Croup* ; Epinephrine ; Fever ; Humans ; Incidence ; Influenza, Human ; Medical Records ; Paramyxoviridae Infections ; Prognosis ; Respiratory Syncytial Viruses ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Rhinovirus