Abstract:
OBJECTIVES:To describe the clinical features, diagnosis, treatment and outcome of children with Kawasaki disease (KD) treated at a large tertiary care Canadian paediatric hospital and to try to identify correlations between clinical features and the development of coronary artery abnormalities. METHODS:The charts of 176 patients diagnosed with typical, atypical or incomplete KD between 1992 and 2000 at British Columbia's Children's Hospital were reviewed. RESULTS:The male to female ratio was 1.8:1. The median age was 2.5 years (range two months to 14 years), with 8% nine years or older (42% Caucasian, 43% Asian). Cases occurred steadily throughout the year. One hundred two (58%) patients had typical, 18 (10%) patients had atypical and 56 (32%) patients had incomplete KD. The median time from fever onset to first intravenous immunoglobulin (IVIG) was seven days (range two to 49 days), and treatment began within 10 days of fever onset in 134 (76%) patients. All patients received one or more doses of 2 g/kg IVIG. Forty-two (24%) patients received a second dose for nonresponsiveness, of whom 10 (6%) remained nonresponsive. Eight (5%) patients received intravenous methylprednisolone. Forty-eight (27%) patients developed coronary artery abnormalities, with 10 (6%) echogenic abnormalities, 25 (14%) dilatations and 13 (7%) aneurysms (seven giant). No patient with a normal echocardiogram at four to eight weeks developed an abnormality on subsequent study. Fourteen (8%) patients had persistent abnormalities at last follow-up (median 447 days, range 62 to 3272 days): seven dilations and seven aneurysms (six giant). Five of 13 children (39%) who developed aneurysms failed to meet diagnostic criteria for typical KD, and three of those five aneurysms were present at less than one year after diagnosis. Four of eight (50%) patients receiving intravenous methyl-prednisolone for IVIG nonresponsiveness had or developed aneurysms. One patient died. CONCLUSION:Some children diagnosed with KD who fail to meet the diagnostic description develop coronary artery abnormalities. There is a need for a more accurate means of diagnosis to more appropriately use IVIG, an expensive and increasingly scarce resource. The role of corticosteroids remains unclear and a randomized controlled clinical trial to determine their role is needed.
journal_name
Paediatr Child Healthjournal_title
Paediatrics & child healthauthors
Ebbeson RL,Riley MR,Potts JE,Human DG,Malleson PNdoi
10.1093/pch/9.7.466subject
Has Abstractpub_date
2004-09-01 00:00:00pages
466-70issue
7eissn
1205-7088issn
1918-1485journal_volume
9pub_type
杂志文章abstract::Hyperbilirubinemia is very common and usually benign in the term newborn infant and the late preterm infant at 35 and 36 completed weeks' gestation. Critical hyperbilirubinemia is uncommon but has the potential for causing long-term neurological impairment. Early discharge of the healthy newborn infant, particularly t...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/12.5.401
更新日期:2007-05-01 00:00:00
abstract::Obesity is recognized by the World Health Organization as an emerging epidemic with significant health risks. This paper outlines the issues for overweight and obese adolescents in Canada, and provides guidelines for providing practical, office-based management in the community. The focus is upon promoting healthy app...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVE:The death of a child is a tragedy resulting in family trauma and disorganization. The present study sought to evaluate the intensity of grief experienced by parents who have lost a child in the perinatal period (stillbirth, premature baby, term baby less than one month) and parents who have lost a child after...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/8.6.363
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Adults discharged from hospital on a Friday are more likely to be readmitted within 30 days than are adults discharged midweek. No study has examined readmission rates for children by day of discharge. OBJECTIVE:To determine the risk of readmission within 30 days by day of discharge in the paediatric popula...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/11.7.409
更新日期:2006-09-01 00:00:00
abstract::Bone marrow aspiration (BMA) and bone marrow trephine biopsy are important procedures for the diagnosis of hematological malignancies and nonmalignant diseases in children. During BMA, bone marrow particles are obtained for analysis including microscopic morphologic evaluations and differential counts. During a trephi...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/13.6.499
更新日期:2008-07-01 00:00:00
abstract::Sexual and reproductive health is an important component of comprehensive health care for youth. This statement provides guidance for selecting and prescribing contraceptives for youth, including commonly prescribed hormonal contraceptives-the pill, patch, ring and injectable progestin-and long-acting reversible contr...
journal_title:Paediatrics & child health
pub_type: 杂志文章,评审
doi:10.1093/pch/pxx192
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of a multidisciplinary paediatric asthma clinic in reducing the morbidity associated with paediatric asthma. METHODS:An initial survey of need was undertaken in the community of Orillia, Ontario and the surrounding area. The clinic was established as a separate entity from the a...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/9.3.159
更新日期:2004-03-01 00:00:00
abstract::Cranial asymmetry occurring as a result of forces that deform skull shape in the supine position is known as deformational plagiocephaly. The risk of plagiocephaly may be modified by positioning the baby on alternate days with the head to the right or the left side, and by increasing time spent in the prone position d...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/16.8.493
更新日期:2011-10-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxy079
更新日期:2019-05-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/3.2.109
更新日期:1998-03-01 00:00:00
abstract::This practice point summarizes the use of antiviral drugs to manage influenza illness in children and youth for the 2012/2013 season. It excerpts a recently published, full-length update of Canadian recommendations for clinicians on the use of antiviral drugs for the prevention and treatment of influenza, with a focus...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:
更新日期:2013-03-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/8.7.433
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:To determine the current prevalence of smoking among First Nations youth living on reserve within the Saskatoon Tribal Council, and to determine the independent risk indicators associated with smoking among First Nations youth. METHODS:Students in grades 5 to 8 attending school within the Saskatoon Tribal Co...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/16.10.e71
更新日期:2011-12-01 00:00:00
abstract::Helicobacter pylori infection is acquired in childhood and plays a causative role in chronic gastritis, peptic ulcer disease and the development of gastric cancer. The present review focuses on recent advances in the management of H pylori infection in children and provides an update of current Canadian guidelines reg...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/9.10.709
更新日期:2004-12-01 00:00:00
abstract::Recreation, globalization, migration, and families visiting friends and relatives (VFRs) overseas have increased the frequency of international travel and potential exposures to tropical diseases. Young infected patients can present a diagnostic challenge to clinicians when they return to Canada, with significant cons...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxy138
更新日期:2018-12-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxx142
更新日期:2017-10-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/5.7.387
更新日期:2000-10-01 00:00:00
abstract::In the past three decades, rapidly changing demographic characteristics have been witnessed in western society. Concurrently, numerous culture-related studies have attested to the disparity in health services among different ethnic groups. Reports have shown contributing factors that can render main stream services in...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/9.9.627
更新日期:2004-11-01 00:00:00
abstract::Concerns about vaccine safety make some parents hesitant about immunization. Health care providers are pivotal in helping parents understand that Canada is a leader in vaccine safety. The present practice point provides an update on the eight components of Canada's vaccine safety system: (1) an evidence-based pre-lice...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxx102
更新日期:2017-07-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
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更新日期:2019-06-24 00:00:00
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journal_title:Paediatrics & child health
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journal_title:Paediatrics & child health
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更新日期:2017-07-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/19.5.261
更新日期:2014-05-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/15.6.373
更新日期:2010-07-01 00:00:00
abstract::The present statement reviews the evidence for universal newborn hearing screening (UNHS). A systematic review of the literature was conducted using Medline and using search dates from 1996 to the third week of August 2009. The following search terms were used: neonatal screening AND hearing loss AND hearing disorders...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/16.5.301
更新日期:2011-05-01 00:00:00
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journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxz018
更新日期:2019-04-01 00:00:00
abstract::Paediatric restless legs syndrome (RLS) treatment is important because RLS's associated sleep disturbance causes significant developmental-behavioural morbidity and impacts family well-being. RLS is associated with brain iron insufficiency and dopaminergic dysfunction. Diagnosis requires fulfillment of diagnostic crit...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/17.4.193
更新日期:2012-04-01 00:00:00
abstract::[This corrects the article DOI: 10.1093/pch/pxy072.]. ...
journal_title:Paediatrics & child health
pub_type: 杂志文章,已发布勘误
doi:10.1093/pch/pxy163
更新日期:2019-02-01 00:00:00
abstract::Parents of children with type 1 diabetes commonly worry about the ability of school personnel to respond to their child's diabetes needs, and may feel anxious about the health, safety and inclusion of their child in school. Physicians may be confronted by parents' fears, anxieties and apprehension, and need to know ho...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/10.1.25
更新日期:2005-01-01 00:00:00
abstract:Objective:To determine if treatment failure varies based on ROME III classification and adherence to guideline congruent therapy among children diagnosed in an emergency department with functional constipation. Methods:Children aged 1 month to 18 years who were diagnosed with constipation in a paediatric emergency dep...
journal_title:Paediatrics & child health
pub_type: 杂志文章
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更新日期:2019-06-01 00:00:00