The purpose of this study was to explore and describe the relationship between the social interaction competence of non-Korean direct-care staff members and Korean American older adults exhibiting behavioral symptoms of dementia (BSDs) who reside in an ethnically specific nursing home. A pilot study was completed to evaluate the feasibility, usability, content validity, and inter-rater reliability of two social interaction-coding schemas, a dementia competence coding schema and a culturally competent coding schema, developed by the principal investigator.In general, there was a negative trend between direct-care staff's dementia competence in social interaction and BSDs that interacted with their level of cultural competence in social interaction. These results suggest that both dementia competent and culturally competent social interactions influence BSDs, although there were morning and afternoon differences. The results provide a foundation that may lead to the development of culturally appropriate and supportive interventions for ethnic minority older adults, as a starting point to improve dementia care for ethnic minority nursing home residents. Implications and recommendations for further studies are presented.
Acute hypoglycemia in children is not an uncommon disease that can be encountered in the Emergency Department. Most cases of childhood hypoglycemia are caused by ketotic hypoglycemia due to missed meals. Often, hypoketotic hypoglycemia can also occur, which suggests hyperinsulinemia or a defect in fatty acid oxidation. Carnitine is essential for long chain fatty acids transfer into mitochondria for oxidation. We present a case of systemic primary carnitine deficiency who presented with seizures due to hypoketotic hypoglycemia. Keywords: Hypoglycemia, Encephalopathy, Systemic carnitine deficiency
Purpose We studied the pathogens and trends in antibiotic sensitivity pattern in children with urinary tract infection (UTI) over 8 years in order to evaluate adequate treatment. Methods We performed a retrospective review of medical records of children with UTI from January 2009 to December 2016 in Daegu Fatima Hospital. Uropathogens and antibiotic sensitivity patterns were selected. Only 1 bacterial species with a colony count of â¥105 CFU/mL was considered a positive result. We compared 2 periods group (A: 2009~2012, B: 2013~2016) to investigate trends of antibiotic sensitivity pattern. Results During the 8 year period, 589 cases are identified (E. coli was cultured in 509 cases, 86.4%). Among all patients, this study investigated the antibiotic sensitivity of E. coli . Antimicrobial susceptibility to ampicillin was steadily low for both periods (A: 32.6%, B: 40.1%, P=0.125), and to amikacin was consistently high for both periods (A: 99.4%, B: 99.3%, P=1.000). Antibiotic sensitivity to third-generation cephalosporin decreased from period A to B (A: 91.7%, B: 75.5%, P=0.000). Antibiotic sensitivity to quinolone significantly decreased from A to B (A: 88.4%, B: 78.2%, P=0.003). The prevalence of extended-spectrum β-lactamase-producing E. coli increased from period A to B (A: 6.1%, B: 17.1%, P=0.000). Conclusion This study showed that conventional antibiotic therapy for the treatment of pediatric UTI needs to be reevaluated. A careful choice of antibiotic is required due to the change in antibiotic sensitivity and the emergence of antibiotic-resistant bacteria. Key words: Urinary tract infection; antibiotic sensitivity; Extended-spectrum β-lactamase
Purpose: To review clinical symptoms, laboratory findings, and treatment of transi ent neonatal hypocalcemia.Method: Medical records of fullterm (gestational age ≥37 weeks) neonates diagnos ed with hypocalcemia, aged <31 days, were investigated retrospectively.Using a cut off of 3 days after birth, cases of neonatal hypocalcemia were classified as early or late.Hypocalcemia was defined as ionized calcium level <4 mg/dL or serum calcium level <7.5 mg/dL.Hyperphosphatemia was defined as serum phosphate level >8 mg/ dL.Relative hypoparathyroidism was defined as hypocalcemia and hyperphospha temia with parathyroid hormone level within the normal range (10-65 pg/mL).Results: Of 68 included neonates, 62 were diagnosed with hypoparathyroidism with hypocalcemia and hyperphosphatemia, and 26 had seizures.Mean serum calcium level of the seizure group was 5.99 mg/dL, which was significantly lower than that of the nonseizure group (6.46 mg/dL, P=0.012).The recovery duration for calcium and phosphate levels was long, at 5.8 and 10.7 days, respectively.The calcium level reco very duration was significantly different between the seizure and nonseizure groups (P=0.034),but the phosphate level recovery period was not significantly different (P=0.194).Of 17 patients with diarrhea, 10 had confirmed rotavirus infec tion.Most patients with hypocalcemia responded well to oral calcium lactate and intravenous calcium gluconate, and the treatments could be discontinued after a certain period.Conclusion: Transient neonatal hypocalcemia is associated with hypoparathyroi dism.The major symptom in late neonatal hypocalcemia was the occurrence of sei zures.Serum calcium level was lower and the recovery period was longer in the seizure group, but most cases exhibited favorable progress.
Purpose : Early surfactant therapy with either gentle ventilation, high-frequency ventilation or aggressive weaning of mechanical ventilation are principles for the treatment of respiratory distress syndrome(RDS). We studied to determine the accessibility of noninvasive nasal continuous positive airway pressure(CPAP) rather than mechanical ventilation by invasive intubation after early surfactant therapy. Methods : The study group consisted of 14 infants who were born and diagnosed with moderate respiratory distress syndrome and received early surfactant therapy with nasal CPAP of PEEP 5-6 cm H2O within two hours after birth in the Fatima neonatal intensive care unit for two years from January 1999 to August 2001. The control group consisted of 15 infants who were diagnosed with the disease and could be weaned from mechanical ventilator within five days after birth during the same period. Results : The characteristics, the severity of clinical symptoms and laboratory findings in the two groups at birth showed no significant difference. Neither did the interim analysis of laboratory data in two groups. Of 14 infants in the study group who received nasal CPAP after early surfactant therapy, only two infants showed weaning failure with this therapy. In the response cases, duration of CPAP was five days and mean airway pressure was 5.4±0.5 cm H2O. Two had the complication of CPAP with abdominal distension. Final complications and outcomes in the two groups showed no signifcant difference(P>0.05). Conclusion : The clinical courses in the two groups showed no significant difference. Therefore, we suggest that early surfactant therapy with noninvasive nasal CPAP is a simple and safe method rather than aggressive weaning after invasive mechanical ventilation in moderate respiratory distress syndrome. (J Korean Pediatr Soc 2002;45:1204-1212)
Children with comorbidities have a higher risk of severe, coronavirus disease 2019 (COVID-19). This study investigated the clinical features and outcomes of COVID-19 in children and adolescents with diabetes between January and March 2022.
Adrenal hypoplasia congenita (AHC) is a rare cause of adrenal insufficiency during neonatal period. Mutations in the gene coding for DAX1 cause X-linked adrenal hypoplasia. Most affected patients are shown to have salt wasting and hyperpigmentation on the skin during the neonatal period and require intensive medical care. In addition, it is usually associated with hypogonadotropic hypogonadism in adolescence. The DAX1 gene is expressed in the adrenal cortex, pituitary gland, hypothalamus, testis, and ovary. We report on a patient with genetically confirmed AHC whose initial clinical presentations were consistent with congenital adrenal hyperplasia. A point mutation in the DAX1 gene identified in this report resulted in a truncated DAX1 protein. Our patient was diagnosed with AHC.
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