• Pediatric Infection and Vaccine
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• 제23권1호
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• pp.1-9
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• 2016

The Zika virus, a flavivirus related to dengue and Japanese encephalitis was discovered in the Zika forest in Uganda, 1947. Since Zika virus was first reported in Brazil in May 2015, infections have occurred in at least 40 countries, especially in the Americas. Zika virus infection usually is asymptomatic or causes mild illness, but may be related to severe clinical manifestations, particularly microcephaly and Guillain-$Barr{\acute{e}}$ syndrome. Although the possibility of autochthonous Zika virus transmission in South Korea is low, the imported cases and Zika virus-transmitting mosquito should be adequately monitored and promptly managed. In addition, enhancing preparedness for Zika virus infection are needed.

• Clinical and Experimental Pediatrics
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• 제64권12호
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• pp.619-627
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• 2021

Pediatric obesity has become a serious public health issue. The prevalence of obesity in children and adolescents has increased worldwide and in Korea over several decades. Obese children are more likely to be obese adults with an increased cardiovascular risk. Therefore, maintaining a healthy weight and preventing obesity during childhood are of critical importance. Moreover, obese children and adolescents often have endocrine comorbidities such as prediabetes, type 2 diabetes, dyslipidemia, metabolic syndrome, polycystic ovary syndrome, and central precocious puberty. Hence, the early implementation of obesity management using a multidisciplinary team approach and screening for these comorbidities in obese children and adolescents are required with the appropriate management of each comorbidity and/or specialist referral.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권4호
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• pp.325-336
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• 2021

The occurrence of functional gastrointestinal disorders (FGIDs) is a formidable challenge for infants, parents, and healthcare professionals. Although data from the Middle East are scarce, experts consider FGIDs a prevalent condition in everyday clinical practice. The new Rome IV criteria revisited the definitions from a clinical perspective to provide a practical and consistent diagnostic protocol for FGIDs. However, the treatment practices for functional disorders vary considerably among Middle Eastern countries, often resulting in mismanagement with unnecessary investigations and treatments. In addition, the role of various treatment modalities, including probiotics such as Lactobacillus reuteri DSM 17938, in FGIDs requires further discussion and evaluation. During a consensus meeting, a locally relevant approach for treating common FGIDs such as infant regurgitation, infant colic, and functional constipation was discussed and approved by regional experts. The participants suggested a simplified treatment plan and protocol for general pediatricians and other primary care physicians managing FGIDs. This easy-to-follow standardized protocol will help streamline the initial management of this complex disorder in the Middle East region and even globally.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권3호
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• pp.153-161
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• 2016

This paper covers algorithms for the management of regurgitation, constipation and infantile colic in infants. Anti-regurgitation formula may be considered in infants with troublesome regurgitation, while diagnostic investigations or drug therapy are not indicated in the absence of warning signs. Although probiotics have shown some positive evidence for the management of functional gastrointestinal disorders (FGIDs), the evidence is not strong enough to make a recommendation. A partially hydrolyzed infant formula with prebiotics and ${\beta}$-palmitate may be considered as a dietary intervention for functional constipation in formula fed infants. Lactulose has been shown to be effective and safe in infants younger than 6 months that are constipated. Macrogol (polyethylene glycol, PEG) is not approved for use in infants less than 6 months of age. However, PEG is preferred over lactulose in infants >6 months of age. Limited data suggests that infant formula with a partial hydrolysate, galacto-oligosaccharides/fructo-oligosaccharides, added ${\beta}$-palmitate may be of benefit in reducing infantile colic in formula fed infants in cases where cow's milk protein allergy (CMPA) is not suspected. Evidence suggests that the use of extensively hydrolyzed infant formula for a formula-fed baby and a cow's milk free diet for a breastfeeding mother may be beneficial to decrease infantile colic if CMPA is suspected. None of the FGIDs is a reason to stop breastfeeding.

• Clinical and Experimental Pediatrics
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• 제63권11호
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• pp.415-421
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• 2020

Cryptorchidism or undescended testis is the single most common genitourinary disease in male neonates. In most cases, the testes will descend spontaneously by 3 months of age. If the testes do not descend by 6 months of age, the probability of spontaneous descent thereafter is low. About 1%-2% of boys older than 6 months have undescended testes after their early postnatal descent. In some cases, a testis vanishes in the abdomen or reascends after birth which was present in the scrotum at birth. An inguinal undescended testis is sometimes mistaken for an inguinal hernia. A surgical specialist referral is recommended if descent does not occur by 6 months, undescended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. International guidelines do not recommend ultrasonography or other diagnostic imaging because they cannot add diagnostic accuracy or change treatment. Routine hormonal therapy is not recommended for undescended testis due to a lack of evidence. Orchiopexy is recommended between 6 and 18 months at the latest to protect the fertility potential and decrease the risk of malignant changes. Patients with unilateral undescended testis have an infertility rate of up to 10%. This rate is even higher in patients with bilateral undescended testes, with intra-abdominal undescended testis, or who underwent delayed orchiopexy. Patients with undescended testis have a threefold increased risk of testicular cancer later in life compared to the general population. Self-examination after puberty is recommended to facilitate early cancer detection. A timely referral to a surgical specialist and timely surgical correction are the most important factors for decreasing infertility and testicular cancer rates.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• 대한장애인치과학회지
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• 제4권1호
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• pp.7-11
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• 2008

치과의사는 혈우병 환자의 치료 시 주의사항에 대해 잘 알고 있어야 한다. 혈우병 환자의 내원 시 소아과 의사 및 혈우재단 등 전문가에게 의뢰하여 환자의 상태에 대한 자문을 얻어야 하고, 치과 치료 시 적절한 계획 하에 최소의 침습적인 치료가 행해지도록 노력해야 하며, 응급 상황을 대비하여 지혈방법을 습득해야 한다. 또 환자와 보호자에게 평소 구강 관리의 중요성을 일깨워 침습적 치과 치료의 빈도를 줄일 수 있도록 해야 한다.

• Clinical and Experimental Pediatrics
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• 제45권11호
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• pp.1332-1339
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• 2002

목 적 : 이 연구는 소아과 진료를 표방하는 1차 의료 기관의 의사를 대상으로 영아기의 영양에 대한 설문 조사를 통해 이들이 영아기 영양에 대하여 얼마나 바르게 상담을 해 주고 있는지를 알아보기 위해 시행하였다. 방 법: 2000년 7월부터 8월까지 대구광역시에서 개원을 하고 있거나 봉직하고 있는 소아과 전문의(1군)와 소아과를 진료과목으로 표방하고 있는 비 소아과 전문의 또는 일반의(2군)를 대상으로 영아기 영양에 관한 육아 상담 내용을 미리 작성한 객관식 10문제를 이용하여 방문조사 하였다. 조사에 참여한 의사는 267명으로 소아과 전문의가 101명, 비 소아과 전문의 또는 일반의가 166명이었다. 비 소아과 전문의는 내과 63명, 일반외과 21명, 산부인과 20명, 가정의학과 16명, 이비인후과 7명, 정신과, 흉부외과, 신경과 전문의가 각각 1명이었다. 전문의 자격이 없는 일반의는 36명이었다. 결 과 : 100점 만점으로 평가한 결과 1군의 점수는 $73.0{\pm}15.8$점, 2군은 $45.1{\pm}18.4$점으로 두 군간에 의미 있는 차이가 있었다(P<0.05). 비소아과 전문의 중 전문 과목에 따른 점수는 내과 전문의가 $46.5{\pm}20.2$, 산부인과 전문의 $44.5{\pm}20.6$, 일반외과 전문의 $40.5{\pm}15.6$, 가정의학과 전문의 $56.3{\pm}16.9$, 이비인후과 전문의 $47.1{\pm}15.0$, 이었고 일반의 $45.3{\pm}16.3$ 점이었으며 타과 전문의와 일반의사 간의 점수사이에 통계적으로 유의한 차이는 관찰되지 않았다. 각 질문 항목에는 모유 수유 권장 기간, 모유 수유 중에 무른 변을 보이는 경우, 모유 수유시에 나타나는 황달의 대처 요령, 이유식의 시작 시기, 시판 이유식을 먹이는 형태, 식물성 분유에 대한 지도 방침, 선식에 대한 지도 방침에 대한 질문에 대한 대답이 1군과 2군 사이에 유의한 차이를 보였다. 결 론 : 본 조사 결과 소아과 전문의들에 비해 타과 전문의들이나 일반의들은 영아기의 영양에 대해 부적절하게 상담하고 있음을 알 수 있었으며, 소아과 전문의들에 대한 지속적인 교육과 함께, 타과 전문의에 의한 부적절한 상담이 이루어지지 않도록 대처하는 방안을 강구해야 할 것으로 사료되었다.

• 대한간호학회지
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• 제30권6호
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• pp.1467-1478
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• 2000

The purpose of this study was to develop a curriculum for the oriental clinical nurse specialist program based on the understanding of Korean human beings so as to develop nursing as a profession and promote the client's health. The design of this study was based on literature review and nominal group study. The research was managed by East-West Nursing Research Institute of nursing science college at Kyung Hee University. The research team was composed of 17 professors of nursing departments of oriental medical colleges. We obtained opinions from Oriental Nurses Association, Oriental Nursing Research Association, and professors in oriental medical college. We reviewed articles, curriculums of other clinical nurse specialist programs, medical laws and the curriculum development plan for the oriental clinical nurse specialist program from Korean Nurses Association. We discussed a curriculum thoroughly in numerous meetings. We developed a following curriculum: 1. Educational philosophy was founded on the oriental human view which was based on Chun-In union theory. It was founded on the oriental health view which recognized health being in harmony with nature and the balance of body function with the harmony of Yin-Yang in the five elements. In addition, it was founded on oriental nursing view to promote these health states. 2. Educational goals were to train oriental clinical nurse specialists, oriental nursing educators and oriental nursing researchers who developed knowledge of oriental nursing theory, nursing practice and created a leadership. 3. Curriculum consisted of 48 credits, of which 36 credits are based on lectures and laboratory classes and 12 credits are based on clinical practice. 36 credits consisted of 5 general subject credits and 31 core subject credits. General subjects consisted of nursing theory, nursing research, law and ethics. Students who had earned master's degrees are not required to take the general subjects. Core subjects consisted of 11 subjects such as advanced physical examination and laboratory, oriental nursing theory, original text of oriental nursing, oriental medical nursing, oriental pediatric nursing, oriental gynecologic nursing, oriental gerontologic nursing, oriental pharmacology, oriental constitutional nursing, advanced nursing of channels and acupuncture points and laboratory and oriental rehabilitation nursing and laboratory. In addition, clinical practice in a hospital ward, out patient department, herb prepation room, department of physical therapy and health promotion center in oriental medical hospitals for 12 weeks. To admit this program, students should complete prerequisites of introduction to oriental nursing and nursing of channels and acupuncture points. 4. Course contents of each subjects were developed to include the course's goal and objectives and specific items. 5. Evaluation involved lecture, laboratory and in field practice. We applied various evaluation systems and methods that were based on both knowledge and skills of the students to ensure full credibility and validity.

• Child Health Nursing Research
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• 제14권1호
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• pp.5-13
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• 2008

Purpose: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. Method: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. Result: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. Conclusion: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.