No abstract

Vital sign monitoring in neonates requires adhesive electrodes, which often damage fragile newborn skin. Because impulse radio ultrawideband (IR-UWB) radar has been reported to recognize chest movement without contact in adult humans, IR-UWB may be used to measure respiratory rates (RRs) in a non-contact fashion. We investigated the feasibility of radar sensors for respiration monitoring in neonates without any respiratory support to compare the accuracy and reliability of radar measurements with those of conventional impedance pneumography measurements. In the neonatal intensive care unit, RRs were measured using radar (RR Rd ) and impedance pneumography (RR IP ) simultaneously. The neonatal voluntary movements were measured using the radar sensor and categorized into three levels (low [M 0 ], intermediate [M 1 ] and high [M 2 ]). RR Rd highly agreed with RR IP ( r = 0.90; intraclass correlation coefficient [ICC] = 0.846 [0.835–0.856]). For the M 0 movement, there was good agreement between RR Rd and RR IP (ICC = 0.893; mean bias −0.15 [limits of agreement (LOA) −9.6 to 10.0]). However, the agreement was slightly lower for the M 1 (ICC = 0.833; mean bias = 0.95 [LOA −11.4 to 13.3]) and M 2 (ICC = 0.749; mean bias = 3.04 [LOA –9.30 to 15.4]) movements than for the M 0 movement. In conclusion, IR-UWB radar can provide accurate and reliable estimates of RR in neonates in a non-contact fashion. The performance of radar measurements could be affected by neonate movement.

Purpose This study aimed to estimate the prevalence, prescription pattern and burden of pediatric asthma in Korea by analyzing the National Health Insurance (NHI) claims data. Methods We retrospectively analyzed the insurance claim records from the Korean NHI claims database from January 2010 to December 2014. Asthmatic patients were defined as children younger than 18 years, with appropriate 10th Revision of the International Classification of Diseases codes (J45 or J46) and a prescription for 1 or more asthma maintenance medications at the same date. Hospitalization and emergency department visits for asthma were defined as use of short-acting beta 2 -agonists during hospital visits among asthmatic patients. Results There were 1,172,807 asthmatic children in 2010, which increased steadily to 1,590,228 in 2014 in Korea. The prevalence showed an increasing trend annually for all ages. The mean prevalence by age in those older than 2 years decreased during the study period (from 39.4% in the 2–3 year age group to 2.6% in the 15–18 year age group). In an outpatient prescription, leukotriene receptor antagonists were the most commonly prescribed medication for all ages. Patients older than 6 years for whom inhaled corticosteroids were prescribed comprised less than 15% of asthmatic patients. The total direct medical cost for asthma between 2010 and 2014 ranged from $376 to $483 million. Asthma-related medical cost per person reached its peak in $366 in 2011 and decreased to $275 in 2014. Conclusions The prevalence of pediatric asthma increased annually and decreased with age. Individual cost of asthma showed a decreasing trend in Korean children.

An accurate method to predict the mortality in the intensive care unit (ICU) patients has been required, especially in children. The aim of this study is to evaluate the value of serum anion gap (AG) for predicting mortality in pediatric ICU (PICU). We reviewed a data of 461 pediatric patients were collected on PICU admission. Corrected anion gap (cAG), the AG compensated for abnormal albumin levels, was significantly lower in survivors compared with nonsurvivors (p < 0.001). Multivariable logistic regression analysis identified the following variables as independent predictors of mortality; cAG (OR 1.110, 95% CI 1.06–1.17; p < 0.001), PIM3 [OR 7.583, 95% CI 1.81–31.78; p = 0.006], and PRISM III [OR 1.076, 95% CI 1.02–1.14; p = 0.008]. Comparing AUCs for mortality prediction, there were no statistically significant differences between cAG and other mortality prediction models; cAG 0.728, PIM2 0.779, PIM3 0.822, and PRISM III 0.808. The corporation of cAG to pre-existing mortality prediction models was significantly more accurate at predicting mortality than using any of these models alone. We concluded that cAG at ICU admission may be used to predict mortality in children, regardless of underlying etiology. And the incorporation of cAG to pre-existing mortality prediction models might improve predictability.

Purpose Egg is the most common food allergen in infants. However, the natural course of egg allergy has not been fully elucidated. This study aimed to describe clinical characteristics and to identify prognostic factors associated with tolerance acquisition of immunoglobulin E (IgE)-mediated egg allergy in children. Methods Children who underwent more than 1 follow-up egg white-specific immunoglobulin E (EWsIgE) test between November 2005 and November 2015 at -Severance Children's Hospital were assessed. Children were diagnosed as having IgE-mediated egg allergy based on immediate allergic reaction after egg consumption and an EWsIgE level of > 0.35 kU/L. The children were divided into “tolerant” and “persistent” groups according to tolerance acquisition defined as egg consumption without adverse allergic reactions. Results Of 124 participants, egg allergy resolved in 101 (81.5%) children. The persistent group had more atopic dermatitis ( P = 0.039), and more wheat ( P = 0.009) and peanut ( P = 0.012) allergies compared to the tolerant group. The EWsIgE levels at diagnosis (EWsIgE diag ) were higher in the persistent group than in the tolerant group ( P = 0.001). The trend of the EWsIgE levels in the tolerant group decreased markedly over time compared to the persistent group ( P < 0.001). In predicting egg allergy tolerance acquisition, the reduction rate of EWsIgE level after 12 months from diagnosis (ΔEWsIgE 12mo ) tended to be more accurate than EWsIgE diag (area under the curve: 0.835 vs. 0.731). When ΔEWsIgE 12mo was ≥ 30%, tolerance acquisition was more frequent than that of < 30% (91.9% vs. 57.9%; P < 0.001). Conclusions ΔEWsIgE 12mo can be used as an early independent predictor of tolerance acquisition of IgE-mediated egg allergy in children.