Pediatrics international : official journal of the Japan Pediatric Society
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The aim of this study was to determine the causative agents in early, late- and very late-onset sepsis in preterm infants. The demographic features, risk factors, clinical and laboratory findings in sepsis types were also defined. ⋯ CONS was found to be the most common causative organism in three sepsis types in preterm neonates. Although the mortality rate due to CONS was lower in EOS, it was an important cause of mortality in LOS and VLOS. CONS seems to be the main pathogen in neonatal sepsis in developing countries, as in developed countries.
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The aim of this study was to investigate the integration of ultrasound (US) findings with Alvarado score in diagnosing or excluding acute appendicitis. ⋯ In the case of non-visualization of the appendix without a high Alvarado score, appendicitis can be safely ruled out.
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Case Reports
Neonatal case of classic maple syrup urine disease: usefulness of (1) H-MRS in early diagnosis.
We describe a male neonate with classic maple syrup urine disease (MSUD) in metabolic crisis. On day 7 of life, he was referred to hospital because of coma and metabolic acidosis with maple syrup odor. On day 4 after admission, brain magnetic resonance imaging findings were consistent with encephalopathy due to MSUD. ⋯ The diagnosis of MSUD was confirmed on low branched-chain α-keto acid dehydrogenase complex activity in lymphocyte. (1) H-MR spectra were obtained in 10 min, while it took at least several days to obtain the results of other diagnostic examinations. In convalescence, the peak at 0.9 p.p.m. decreased. The large methyl resonance peak at 0.9 p.p.m. in brain (1) H-MRS would be one of the earliest clues to the diagnosis of classic MSUD in the neonatal period, especially in metabolic crisis.
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The aim of this study was to assess correlations between demographic, clinical and laboratory characteristics and the risk of serious bacterial infection (SBI) in febrile <90-day-old infants. ⋯ Of the clinical and laboratory variables selected for evaluation, qualitative CRP was the strongest independent predictor for diagnosing SBI and a significantly better diagnostic marker than clinical characteristics, ANC and white blood cell count.
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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.