PurposeLong-acting gonadotropin-releasing hormone agonists (GnRHa) are commonly used to treat central precocious puberty (CPP) in Korea. Although rare, there have been reports on the characteristic of adverse reactions of GnRHa in CPP among the Korean population. This study was intended to report on our clinical experience regarding significant adverse reactions to long-acting GnRHa in CPP and early onset puberty and to evaluate the prevalence rate of serious side effects.MethodsThis retrospective study included children with CPP and early onset puberty, who were administered monthly with long-acting GnRHa (leuprolide acetate, triptorelin acetate) at the outpatient clinic of Department of Pediatrics, at Inha University Hospital, between January 2011 and December 2013. We analyzed the clinical characteristics of patients who experienced significant adverse reactions and evaluated the prevalence rate.ResultsSix serious side effects (0.9%) were observed among total of 621 CPP and early onset puberty children with GnRHa therapy. The number of sterile abscess formation was four in three patients (4 events of 621). Anaphylaxis occurred in only one patient, and unilateral slipped capital femoral epiphysis (SCFE) in another one patient. Anaphylaxis occurred after the 6th administration of the monthly depot triptorelin acetate. Unilateral SCFE developed in GnRHa therapy.ConclusionSterile abscess formation occurred in 0.6% of CPP and early onset puberty patients from the administration of a monthly depot GnRHa therapy. The occurrences of anaphylaxis and SCFE are extremely rare, but can have serious implications on patients. Clinicians should be aware of these potential adverse effects related to GnRHa therapy in CPP.

Purpose: The characteristics of allergic rhinitis can be different among countries and areas because causative allergens and aggravating factors depend on the living environment. However, there have been few studies on the clinical feature of Korean children with allergic rhinitis, as well as on clinical characteristics in different age groups. The aim of this study was to investigate the clinical characteristics of Korean children with allergic rhinitis. Methods: The medical records of children under 12 years of age who had rhinitis symptoms were analyzed in terms of clinical symptoms and positive allergens. Subjects were classified into 2 groups: those with allergic rhinitis (AR group) and nonallergic rhinitis (NAR group). Both groups were subdivided into 3 categories: the 1-4 years, 5-8 years, and 9-12 age groups. Results: Among 516 children, 397 (76.94%) belonged to the AR group and 119 (23.06%) belonged to the NAR group. The male to female ratios were 2:1 in both groups. There were significant differences in sneezing and itching between the AR and NAR groups across different age subgroups. There were significant differences in nasal obstruction between the AR and NAR groups in the 9-12 age group. The incidence of AR was 77.8 % in chronic sinusitis patients. Sensitized allergens were house dust mites, animal hair, pollen, and mold in decreasing order in the AR group. Children who were sensitized to animal hair more frequently had sneezing than those who were not. Conclusion: Sneezing and itching strongly suggest allergic rhinitis in Korean children. Clinical characteristics of allergic rhinitis in Korean children would helpful in early diagnosis and adequate treatment of disease. (Allergy Asthma Respir Dis 2015;3:116-123) 서 론 알레르기비염(allergic rhinitis)의 유병률은 현재 전세계 인구의 40% 이상, 1,2) 유럽 인구의 23%-30%, 3,4) 미국의 12%- 30% 5) 로 이로 인한 사회적 부담이 매우 크다. 국제아동천식 및 알레르기질환 역 학조사 3상(International Study of Asthma and Allergies in Childhood [ISAAC] study phase 3)에 따르면 알레르기비염 유병률은 나 이지리아의 3.6%부터 파라과이의 45.1%까지 나라마다 매우 큰 차 이를 보이고 있다. 6) 국내 초등학생의 알레르기비염 진단 유병률은 1995년 15.5%, 2000년 20.4%, 2006년 28.5%, 2010년 29.9%로 지속 적으로 증가하는 경향을 보이고 있다. 7-9) 산업화에 의한 대기오염의 증가, 식이 습관, 주거 및 생활환경의 변화, 위생가설 등이 질환 유병 률 증가의 주요한 원인으로 대두되고 있다. 10-12) 이처럼 국가 간, 지역 간 알레르기비염 유병률의 차이는 유전적인 요인 이외의 환경적인 요인에 기인한다. 알레르기비염은 비점막이 알레르겐에 노출된 후 일어나는 IgE 매개성 염증 반응에 의한 질환으로, 주요 증상은 수양성 콧물, 재채 기, 코막힘, 코 또는 눈의 가려움 등이다. 1) 그러나 약물, 바이러스 감 염 등에 의한 코 증상도 이와 유사하여 증상만으로는 알레르기비 염과 비알레르기비염(nonallergic rhinitis)을 구별하는 것이 쉽지 Allergy Asthma Respir Dis 3(2):116-123, March 2015 http://dx.

PurposeKorean children have their own unique lifestyle based on their living environment and culture. This study aimed to develop a questionnaire to evaluate the quality of life in Korean children with allergic rhinitis.MethodsAfter a preliminary survey, an initial questionnaire was developed. Questions were modified to be easily understood by young children aged 6 to 7 years. The modified questionnaire was tested on children aged 6 to 12 years old. Item scores, defined as the proportion of children whose answer score was 1 point or higher was multiplied by the average answer score of each question, were used to identify questions that have practical application to the quality of life in Korean children with allergic rhinitis. Differences in answer scores between children with allergic rhinitis and those who were healthy were assessed by a Wilcoxon rank-sum test. The relationship between nasal index scores and quality of life scores was determined by a Spearman rank order test.ResultsAn initial questionnaire was composed of 21 items. We identified 19 questions with item scores above 0.5 in children with allergic rhinitis, many of which were related to nasal symptoms and 10 questions that were different between the allergic rhinitis group and the control group. The final questionnaire included the 10 questions that had both high item scores and a significant difference in the answer scores between the two groups.ConclusionsThe developed questionnaire is essential and practical for assessing discomfort related to the symptoms felt by Korean children with allergic rhinitis.

The most effective method for prevention of diabetes in a pre-diabetic patient is improvement in life style. Thus, methods of nursing management rely on diabetes prevention education. A pre-diabetic patient needs to receive accurate diagnosis and undergo regular checkups focusing on diabetes through physician counseling. As diabetes education focuses on habit improvement including dietary therapy, exercise, and weight maintenance, efforts are needed to decrease risk factors of diabetes. Pre-diabetes education helps to prevent diabetes. Hence, general diabetes education and support should start in the pre-diabetic stage.