Acta paediatrica Japonica; Overseas edition
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Several quantitative methods of urine microscopic examination for bacteriuria and pyuria on a blood cell counting-chamber have been found reliable for the diagnosis of urinary tract infection (UTI). However, no one technique has become popular or widely used because of laborious procedures associated with the method. We investigated the usefulness of microscopic examination of uncentrifuged urine on disposable counting-chambers. ⋯ The positive predictive value of concomitant bacteriuria and pyuria was 100%. When neither bacteriuria nor pyuria was found, the negative predictive value was 100%. It was concluded that urine microscopy using disposable counting chambers was very easy, inexpensive, quick and reliable and thus an extremely useful method for diagnosing UTI.
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Access to artificial surfactant and high frequency oscillatory ventilation (HFO) in Japan seems to affect the actual indications for extracorporeal membrane oxygenation (ECMO). The relation between the methods of treatment and survival and/or neurological sequelae of 27 neonates with severe respiratory failure who would have met the US ECMO entry criteria in the Neonatal Intensive Care Unit of National Children's Hospital, Tokyo between January 1988 and May 1992 were retrospectively analyzed. Out of 27 neonates, conventional treatment including artificial surfactant was successful in 6 cases (22%). ⋯ Only about 1% of the neonates who were admitted to our NICU during the last 4 years needed ECMO treatment. Forty-one per cent of the patients who would have met the US ECMO entry criteria were treated successfully without ECMO. The necessity for ECMO is less in Japan than in the US because other methods can often be used successfully to treat severe respiratory disorders.
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Comparative Study
Toward better home respiratory monitoring: a comparison of impedance and inductance pneumography.
Various respiratory monitoring methods have been used as a part of home respiratory care, but none has been accepted as a universal method. Impedance pneumography is the most popular method at present and is used in the form of cardiorespiratory monitoring, but it has limitations for diagnosing obstructive airway problems and a high incidence of false alarms. We evaluated a new investigational method, inductance pneumography, in terms of the incidence of false alarms (waveform out of range), using infants recovering from general anesthesia. ⋯ Electrocardiography electrodes for impedance pneumography dislodged briefly in one case but the Respiband dislodged in four cases and the Flex II probe dislodged in three cases, indicating the need for better fixation of sensors. It was found that inductance pneumography, in addition to being able to detect obstructive apnea, has a significantly lower incidence of false alarms. Further elaboration of this method is warranted for better home respiratory monitoring.
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This study evaluated the efficacy of a new patient-triggered ventilator that triggered the patient's inspiratory effort by detecting the change in airflow by means of a 'hot wire' anemometer. This ventilator was used in both the conventional and the synchronized intermittent mandatory ventilation (SIMV) modes in seven neonates. Values for blood gas, spontaneous breathing rate, tidal volume of spontaneous breaths and minute volume were compared in all seven neonates. ⋯ The tidal volume of spontaneous breaths was more constant with SIMV versus conventional mechanical ventilation. Thus, the airway flow-triggered SIMV may lessen inspiratory muscle fatigue during weaning process. We conclude that the SIMV is useful in weaning neonates from the ventilator.
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Nepal is among the 20 countries with the lowest human development index, according to the criteria of the United Nations Development Program (UNDP), and has a very high under-five mortality rate, according to the United Nations Children's Fund (UNICEF). In December 1992, the Japan Medical Association (JMA) and the Japan International Cooperation Agency (JICA) began jointly carrying out a maternal and child health (MCH) project. Its beneficiaries are the population of Kavre District, the District Public Health Office in Kavre, the Central Region Health Directorate, and the Ministry of Health of Nepal. ⋯ This is the first cooperative project organized by JICA that involves the participation of a non-governmental organization, in this case, the JMA. The JMA will construct the primary Health Care (PHC) Center, equip it with a dormitory and safe water supply system, and provide sufficient drugs for 2 years. The Japan International Cooperation Agency will dispatch MCH experts and provide medical equipment and supplies.(ABSTRACT TRUNCATED AT 250 WORDS)