Pediatrics international : official journal of the Japan Pediatric Society
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Limited data are available related to the effects of cardiovascular risk factors on abdominal arterial stiffness using carotid and brachial artery indices. Therefore, we aimed to determine arterial changes in obese children and investigate any relation with cardiovascular risk factors. ⋯ Abdominal arterial stiffness parameters as well as carotid intima-media thickness and brachial arterial flow-mediated dilatation assessment were similarly useful in identifying obese children with cardiovascular risk factors. Insulin resistance is related with the augmented rigidity of the aortic wall in obese children.
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Thrombolytic therapy for coronary aneurysm thrombosis of Kawasaki disease (KD) includes antiplatelet and anticoagulants, i.v. coronary thrombolysis (IVCT), and i.c. thrombolysis (ICT). Therapeutic methods, drugs and doses vary among medical facilities. ⋯ In the present nationwide survey, thrombolytic therapy was more effective in cases of a shorter duration between thrombus formation and the start of treatment. It was found that many facilities used only IVCT for thrombus alone. Medications given to KD children did not cause serious hemorrhagic complications, unlike in adults. Although doses exceeded recommended levels in many cases, the only complications were nasal bleeding and fever.
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Comparative Study
Use of non-invasive total hemoglobin measurement as a screening tool for anemia in children.
Universal screening for anemia is important in children, but invasive blood sampling is required. A new device (Radical-7® Pulse CO-Oximeter™, Masimo, Irvine, CA, USA) now enables non-invasive hemoglobin concentration (SpHb) measurement to be done, but the usefulness of this device for anemia screening in children is unclear. The objective of this study was to compare SpHb with complete blood count (CBC) using a hematology analyzer (Microsemi® LC-667CRP; Fukuda Denshi, Tokyo, Japan). ⋯ The correlation of Radical-7® and Microsemi® was 0.602 (P < 0.0001). On Bland-Altman comparison, bias was -0.6 ± 1.1 g/dL. Even though further improvement is required, Radical-7® offers many possibilities in the context of primary screening.
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Several drugs, when used chronically in very preterm infants, are considered to be associated with the development of late-onset circulatory collapse (LCC), which can lead to neurodevelopmental impairment. Despite its clinical importance, conclusive risk factors for LCC have yet to be identified. The aim of the present study was to investigate the relationship between LCC and diuretics, methylxanthines, levothyroxine, and sodium chloride. ⋯ Methylxanthine use was significantly associated with LCC onset. Diuretics may have the ability to provoke LCC through sodium wasting, resulting in a negative balance of the electrolyte. The incidence of LCC could be lowered by paying particular attention to infants' sodium balance, and by aggressive methylxanthine treatment.