Journal of Yeungnam Medical Science

Focused Review articles

The prevalence and prevention strategies of pediatric obesity: a narrative review: Mi Seon Lee; J Yeungnam Med Sci. 2024;41(3):141-149. Published online July 5, 2024; DOI: https://doi.org/10.12701/jyms.2024.00346

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Pediatric obesity has rapidly increased globally over the past few decades, including in Korea. We aimed to discuss trends in the prevalence of pediatric obesity and effective prevention strategies. Its prevalence has markedly increased in most high-income nations. According to recent reports, this increase has slowed in developed countries, but the levels remain alarmingly high. In Korea, the rate of pediatric obesity has surged notably since the 1990s; however, since the 2000s, this increase has become more gradual. According to recently published 2017 growth charts, the prevalence of pediatric obesity in Korea varies slightly depending on the data source. The National School Health Examination data showed that pediatric obesity gradually increase from 11.5% in 2014 to 15.1% in 2019, and after the coronavirus disease 2019 pandemic, it sharply increased to 19% in 2021. Based on data from the Korea National Health and Nutrition Examination Survey, the prevalence of pediatric obesity gradually increased from 10.8% in 2017 to 13.6% in 2019. This trend, which accelerated sharply to 15.9% in 2020 and 19.3% in 2021, was especially severe in boys and older children. Pediatric obesity not only affects health during childhood but also increases the risk of developing obesity and associated health conditions in adulthood. Despite ongoing research on treatment options, obesity prevention and control remain challenging. Hence, prioritizing early intervention and prevention of pediatric obesity through healthy eating habits and lifestyles is crucial. This requires intervention at the individual, family, school, and community levels.

Citations

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Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

Effective and appropriate use of weight loss medication in pediatric obesity: a narrative review: Yoojin Lindsey Chung; J Yeungnam Med Sci. 2024;41(3):158-165. Published online July 2, 2024; DOI: https://doi.org/10.12701/jyms.2024.00353

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Abstract PDF

Over the past few decades, there has been a notable increase in the incidence of pediatric obesity, which is a significant public health concern. Children who are obese have a greater risk of type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is typically the initial approach to treat pediatric obesity. For patients who do not achieve success with lifestyle modification therapy alone, pharmacotherapy is the next logical treatment option. When selecting an anti-obesity medication (AOM), it is essential to first ascertain the medical background of the patient, including current medications and obesity-associated comorbidities. Evaluation of obesity phenotypes in patients may also be beneficial. AOMs for pediatric obesity include metformin, orlistat, glucagon-like peptide 1 agonists, phentermine, and the phentermine/topiramate combination. Sufficient lifestyle modification therapy should be administered before considering pharmacotherapy and continued after the initiation of AOM. To ensure healthy development, monitoring growth and puberty development during anti-obesity treatments is essential.

Citations

Citations to this article as recorded by

Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

What is the disease burden from childhood and adolescent obesity?: a narrative review: Eun Byoul Lee; J Yeungnam Med Sci. 2024;41(3):150-157. Published online June 27, 2024; DOI: https://doi.org/10.12701/jyms.2024.00360

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Abstract PDF

The prevalence of childhood and adolescent obesity has increased and exacerbated during the coronavirus disease 2019 pandemic, both in Korea and globally. Childhood and adolescent obesity poses significant risks for premature morbidity and mortality. The development of serious comorbidities depends not only on the duration of obesity but also on the age of onset. Obesity in children and adolescents affects almost all organ systems, including the endocrine, cardiovascular, gastrointestinal, reproductive, nervous, and immune systems. Obesity in children and adolescents affects growth, cognitive function, and psychosocial interactions during development, in addition to aggravating known adult comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cancer. Childhood and adolescent obesity are highly associated with increased cardiometabolic risk factors and prevalence of metabolic syndrome. The risk of cardiovascular and metabolic diseases in later life can be considerably decreased by even a small weight loss before the onset of puberty. Childhood and adolescent obesity is a disease that requires treatment and is associated with many comorbidities and disease burdens. Therefore, early detection and therapeutic intervention are crucial.

Citations

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Exploring comprehensive insights into pediatric obesity
Yong Hee Hong
Journal of Yeungnam Medical Science.2024; 41(3): 139. CrossRef

Original article

Enhancing ketamine anesthesia with midazolam and fentanyl for children’s ear surgery: a prospective randomized study: Seong Min Han, So Young Kwon, Jang Hyeok In, Jin Deok Joo; J Yeungnam Med Sci. 2024;41(3):207-212. Published online May 23, 2024; DOI: https://doi.org/10.12701/jyms.2024.00276

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Abstract PDF: Background
Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery.
Methods
This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 μg/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores.
Results
The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group.
Conclusion
Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

Review article

Pediatric headache: a narrative review: Saeyoon Kim; J Yeungnam Med Sci. 2022;39(4):278-284. Published online September 14, 2022; DOI: https://doi.org/10.12701/jyms.2022.00528

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Abstract PDF

Headache is one of the most common neurological disorders in children and adults and can cause significant distress and disability in children and their families. The spectrum of pediatric headaches is broad, and the underlying etiology is variable. The symptoms and phenotypes of headaches in children may differ slightly from those in adults. It is important to have a good understanding of headaches in children and to distinguish between primary and secondary headaches through appropriate history assessment and neurological examination. Accurate diagnosis and appropriate drug selection are helpful for effective treatment. This article reviews headaches in children and adolescents, focusing on approaches for diagnosis and management.

Citations

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Exploring downstream effects of gender roles in healthcare decision-making and relationships within systems: A cross-sectional analysis of openness to treatment in pediatric headache
Zoë Schefter, Allison M. Smith
Journal of Psychosomatic Research.2024; 179: 111611. CrossRef
Occipital nerve stimulation in pediatric patients with refractory occipital neuralgia
James Mossner, Nour B. Saleh, Maryam N. Shahin, Joshua M. Rosenow, Jeffrey S. Raskin
Child's Nervous System.2024; 40(8): 2465. CrossRef
MRT bei kindlichen Kopfschmerzen
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Kinder- und Jugendmedizin.2024; 24(04): 296. CrossRef
An Evaluation of Previously Undiagnosed Childhood Primary Headache Cases Through Their EEG and MR Findings
Selcan Öztürk, Erdal Komut
The Journal of Pediatric Research.2024; : 129. CrossRef
The Photo- and Phonosensitivity Avoidance Behavior Scales: Evaluating Clinical Utility in Pediatric Primary Chronic Headache
Allison M. Smith, Megan N. Silvia, Hannah Rogan, Alyssa A. Lebel
Children.2024; 11(11): 1338. CrossRef
Multivariate prediction of long COVID headache in adolescents using gray matter structural MRI features
Minhoe Kim, Sunkyung Sim, Jaeseok Yang, Minchul Kim
Frontiers in Human Neuroscience.2023;[Epub] CrossRef

Original article

Pediatricians’ perception of factors concerning the clinical application of blockchain technology to pediatric health care: a questionnaire survey: Yong Sauk Hau, Min Cheol Chang, Jae Chan Park, Young Joo Lee, Seong Su Kim, Jae Min Lee; J Yeungnam Med Sci. 2023;40(2):156-163. Published online July 18, 2022; DOI: https://doi.org/10.12701/jyms.2022.00241

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Abstract PDF Supplementary Material: Background
Interest in digital medical information has increased because it allows doctors to easily access a patient’s medical records and provide appropriate medical care. Blockchain technology ensures data safety, reliability, integrity, and transparency by distributing medical data to all users over a peer-to-peer network. This study attempted to assess pediatricians’ thoughts and attitudes toward introducing blockchain technology into the medical field.
Methods
This study used a questionnaire survey to examine the thoughts and attitudes of 30- to 60-year-old pediatricians regarding the introduction of blockchain technology into the medical field. Responses to each item were recorded on a scale ranging from 1 (never agree) to 7 (completely agree).
Results
The scores for the intentions and expectations of using blockchain technology were 4.0 to 4.6. Pediatricians from tertiary hospitals responded more positively (4.5–4.9) to the idea of using blockchain technology for hospital work relative to the general population (4.3–4.7). However, pediatricians working in primary and secondary hospitals had a slightly negative view of the application of blockchain technology to hospital work (p=0.018).
Conclusion
When introducing the medical records of related pediatric and adolescent patients using blockchain technology in the future, it would be better to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. The cost, policy, and market participants’ perceptions are essential factors to consider when introducing technology in the medical field.

Review article

Drug selection for sedation and general anesthesia in children undergoing ambulatory magnetic resonance imaging: Sung Mee Jung; Yeungnam Univ J Med. 2020;37(3):159-168. Published online April 17, 2020; DOI: https://doi.org/10.12701/yujm.2020.00171

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Abstract PDF

The demand for drug-induced sedation for magnetic resonance imaging (MRI) scans have substantially increased in response to increases in MRI utilization and growing interest in anxiety in children. Understanding the pharmacologic options for deep sedation and general anesthesia in an MRI environment is essential to achieve immobility for the successful completion of the procedure and ensure rapid and safe discharge of children undergoing ambulatory MRI. For painless diagnostic MRI, a single sedative/anesthetic agent without analgesia is safer than a combination of multiple sedatives. The traditional drugs, such as chloral hydrate, pentobarbital, midazolam, and ketamine, are still used due to the ease of administration despite low sedation success rate, prolonged recovery, and significant adverse events. Currently, dexmedetomidine, with respiratory drive preservation, and propofol, with high effectiveness and rapid recovery, are preferred for children undergoing ambulatory MRI. General anesthesia using propofol or sevoflurane can also provide predictable rapid time to readiness and scan times in infant or children with comorbidities. The selection of appropriate drugs as well as sufficient monitoring equipment are vital for effective and safe sedation and anesthesia for ambulatory pediatric MRI.

Citations

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Prioritisation of data-poor pharmaceuticals for empirical testing and environmental risk assessment
Cristiana Cannata, Thomas Backhaus, Irene Bramke, Maria Caraman, Anna Lombardo, Rhys Whomsley, Caroline T.A. Moermond, Ad M.J. Ragas
Environment International.2024; 183: 108379. CrossRef
Review of pediatric sedation and anesthesia for radiological diagnostic and therapeutic procedures
Mohammed Ageel
Journal of Radiation Research and Applied Sciences.2024; 17(1): 100833. CrossRef
Comparison of airway collapsibility following single induction dose ketamine with propofol versus propofol sedation in children undergoing magnetic resonance imaging: A randomised controlled study
Pooja Bhardwaj, Sakthirajan Panneerselvam, Priya Rudingwa, Kirthiha Govindaraj, M.V.S. Satya Prakash, Ashok S. Badhe, Krishnan Nagarajan
Indian Journal of Anaesthesia.2024; 68(2): 189. CrossRef
A Narrative Review of the Efficacy and Safety of Oral Ketamine in Pediatric Sedation: A Critical Analysis of Current Evidence
Lakshmi Naga Sai Sivani Dasari, Sanjot Ninave
Cureus.2024;[Epub] CrossRef
Evaluating Sedation Strategies for Magnetic Resonance Imaging: A Comprehensive Review of Intravenous Fentanyl, Butorphanol, and Midazolam in Adult and Pediatric Populations
Neeta Verma, Janhavi S Dahake
Cureus.2024;[Epub] CrossRef
Efficacy and Safety of Dexmedetomidine Compared to Other Needle-Free Pharmacological Sedation Methods in Pediatric Patients Undergoing Imaging Procedures
Mohammed Alsabri Hussein Alsabri, Abdelrahman Abdelshafi, Ahmed Bostamy Elsnhory, Noha Samir Selim, Alaa Bostamy Elsnhory, Douaa Albelal, Fatima Akram, Alaa Ahmed Elshanbary
Pediatric Emergency Care.2024; 40(9): e233. CrossRef
Adverse events and sedation characteristics of propofol and dexmedetomidine during magnetic resonance imaging: An observational study in neuropsychiatric population
Shyamala Narayanan, Sriganesh Kamath, Dhritiman Chakrabarti
Journal of Neurosciences in Rural Practice.2024; 0: 1. CrossRef
Sedation and anesthesia for imaging of the infant and neonate—a brief review
Forrest P. Beaulieu, Gabriel Zuckerberg, Kristen Coletti, Emily Mapelli, John Flibotte, Spoorthi Sampath, Misun Hwang, Elizabeth T. Drum
Pediatric Radiology.2024; 54(10): 1579. CrossRef
A Comprehensive Review on the Role of MRI in the Assessment of Supratentorial Neoplasms: Comparative Insights Into Adult and Pediatric Cases
Paritosh N Bhangale, Shivali V Kashikar, Paschyanti R Kasat, Priyal Shrivastava, Anjali Kumari
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Meta-analysis study on anesthetic sedation recovery and onset times in pediatric and elderly patients undergoing CT and MRI
Qiong Zhao, Fei Meng, Huimei Han, Lili Han
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Comparison of oral triclofos and intranasal midazolam and dexmedetomidine for sedation in children undergoing magnetic resonance imaging (MRI): an open-label, three-arm, randomized trial
Shyam Chandrasekar, Bhagirathi Dwibedi, Rashmi Ranjan Das, Biswa Mohan Padhy, Bikram Kishore Behera
European Journal of Pediatrics.2023; 182(3): 1385. CrossRef
Correlation between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients in South Korea: a prospective cohort study
Mijung Park, Ji Um, So Hyun Kim, Jiseon Yoon, Yeonjae Lee, Jiyeong Kwon, Seonhee Baek, Dong Yeon Kim
Child Health Nursing Research.2023; 29(1): 51. CrossRef
COMPARISON OF INTRAMUSCULAR VERSUS INTRAVENOUS KETAMINE FOR SEDATION IN CHILDREN UNDERGOING MAGNETIC RESONANCE IMAGING EXAMINATION
Jasim M. Salman, Jasim N. Al-Asadi, Husham H. Abdul-Ra’aoof, Jawad H. Ahmed, Ali H Reshak
Wiadomości Lekarskie.2023; 76(1): 198. CrossRef
Does sevoflurane sedation in pediatric patients lead to “pseudo” leptomeningeal enhancement in the brain on 3 Tesla magnetic resonance imaging?
Kiran Hilal, Kumail Khandwala, Saima Rashid, Faheemullah Khan, Shayan Sirat Maheen Anwar
World Journal of Radiology.2023; 15(4): 127. CrossRef
Intranasal dexmedetomidine versus intranasal midazolam as sole sedative agents for pelviabdominal magnetic resonance imaging in pediatrics: A randomized double-blind trial
TaysserM Abdelraheem, HamdyA Hendawy, AmiraM Elkeblawy
Bali Journal of Anesthesiology.2023; 7(2): 99. CrossRef
Prospective, randomized, double-blind, double-dummy, active-controlled, phase 3 clinical trial comparing the safety and efficacy of intranasal dexmedetomidine to oral midazolam as premedication for propofol sedation in pediatric patients undergoing magnet
Olivia Nzungu Wabelo, Denis Schmartz, Mario Giancursio, Françoise De Pooter, Giulia Caruso, Jean-François Fils, Philippe Van der Linden
Trials.2023;[Epub] CrossRef
The effect of age on outpatient pediatric procedural sedation with intranasal dexmedetomidine and oral midazolam
Xiaqing Zhou, Jialian Zhao, Haiya Tu, Kunwei Chen, Yaoqin Hu, Yue Jin
European Journal of Pediatrics.2023; 183(1): 169. CrossRef
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Mengchun Sun, Benzhang Tao, Gan Gao, Hui Wang, Aijia Shang
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Yutaka Konda, Hajime Mihira, Louis Akiyama, Yuki Shiko, Yoshihito Ozawa, Yohei Kawasaki, Katsunori Fujii, Ryugo Hiramoto
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Psychiatric outcomes following ketamine administration for orthopedic surgical anesthesia
Alec E. Mansour, Elijah W. Hale, Daniel S. Saks
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Case Report

Pediatric Crohn's Disease presenting as Severe Constipation and Abdominal Distension.: Myong Soon Sung, Seok Jeong Kang, Kwang Hae Choi; Yeungnam Univ J Med. 2008;25(2):139-144. Published online December 31, 2008; DOI: https://doi.org/10.12701/yujm.2008.25.2.139

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Abstract PDF: Crohn's disease is a chronic inflammatory bowel disease that mainly affects children and young adults. Its cause remains unknown. The incidence of pediatric Crohn's disease is increasing, so it is important for clinicians to be aware of the presentation of this disease in the pediatric population. The majority of patients complain of abdominal pain (72%), with only 25% presenting with the 'classical triad' of abdominal pain, weight loss, and diarrhea. Many children with Crohn's disease present in a 'non-classical' manner, with vague complaints such as lethargy or anorexia, which may be associated with only mild abdominal discomfort. Other symptoms include fever, nausea, vomiting, growth retardation, malnutrition, delayed puberty, psychiatric symptoms, arthropathy, and erythema nodosum. Severe constipation and abdominal distension are uncommon symptoms at diagnosis. We report a case of pediatric Crohn's disease, which was diagnosed after the patient presented with severe constipation and abdominal distension.

Original Article

Clinical Outcome of Ureteropelvic Junction Obstruction in the Pediatric and Adult Population.: Phill Hyun Song, Sang Taek Kwon, Ji Hyun Yeo, Yong Hoon Park, Ki Hak Moon; Yeungnam Univ J Med. 2004;21(1):67-73. Published online June 30, 2004; DOI: https://doi.org/10.12701/yujm.2004.21.1.67

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Abstract PDF: BACKGROUND
A ureteropelvic junction (UPJ) obstruction is a congenital anomaly commonly afflicting the pediatric population. However, it occurs more frequently in adults than is generally appreciated. To assess their characteristics, we have here compared and analyzed the clinical manifestations, causes, and outcomes of UPJ obstruction found in children and adults. MATERIALS AND METHODS: 102 patients (118 renal units) out of 182 patients (218 renal units), with diagnosed UPJ obstruction, were available for follow up. The follow-ups were retrospectively reviewed to determine the presenting symptoms, treatments, and clinical outcomes. Patients who were younger than 18 years of age were assigned to the pediatric group (44 patients), others the adult group (58 patents). RESULTS: The majority of the patients presented with flank pain (pediatric group: 68%, adult group: 76%). The majority of patients underwent a pyeloplasty (pediatric group: 50.9%, adult group: 62.3%). And the major cause of the UPJ obstruction was an intrinsic stenosis (pediatric group: 53%, adult group: 56%). CONCLUSION: The prevalence of bilateral UPJ obstruction in adults is evidently less prevalent than in pediatrics, and despite the late diagnosis, the surgical outcome is similar. A further investigation of UPJ obstruction will lead us to a more comprehensive understanding of the disease.

Review

Pediatric Outpatient Anesthesia.: Il Sook Seo; Yeungnam Univ J Med. 2001;18(2):145-169. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.145

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Abstract PDF: In recent years, health care cost containment concerns have resulted in an increase in outpatient (or same-day) surgery. Many procedures previously performed on an inpatient surgery basis have been shifted to outpatient settings. Anesthesia for outpatient surgery is exactly the same as inpatient anesthesia, except that the primary concern is the selection of patients who can be discharged safely on the day of surgery. The anesthesiologist should have a sound rational basis for choice of pharmacologic agents that are geared to expeditious patient discharge from the hospital. Cost concerns aside, outpatient surgery has many additional advantages in the pediatric setting. It minimizes the length of time the child is hospitalized, decreases separation anxiety, promotes parental involvement in the child's postoperative care in the more congenial environment of home, and decreases risk of nosocomial infection and iatrogenic illness.

Original Articles

Statistical analysis of patients referred to pediatric cardiologic clinic for diagosis of heart disease.: Kwang Hae Choi, Young Hwan Lee; Yeungnam Univ J Med. 2000;17(1):49-54. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.49

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Abstract PDF

BACKGROUND
Echocardiography is rapidly established itself as the primary diagnostic technique for investigation of children with heart disease, and referrals are increasing to the pediatric cardiology clinic for investigation. However, because there is a lack of analysis data on the patients referred to pediatric cardiology clinics, we have proceeded to compare and analyze their characteristics to provide basic data base. METHODS: From Oct. 1, 1998 to Jul. 10, 1999, total 443 cases referred to the pediatric cardiology clinic of Yeungnam University Hospital were studied retrospectively by medical records, chest X-ray, EKG and echocardiography, etc. RESULTS: The results were as follows. 1. The proportion of male was 61.0%(261 cases) and that of female was 39.0%(167 cases). The ratio of male to female was 1.6:1. The proportion infants less than 1 year-old was 62.6%(268 cases) of all patients. 2. Cardiac murmur was present in 248 cases(57.9%), which was the most common case of referral to the pediatric cardiology clinic. The impression at referral was more congenital heart disease(70.6%) than acquired heart disease(17.8%) and arrhythmia(11.6%). 3. The final diagnosis was as follows : congenital heart disease was present in 212 cases(49.5%), acquired heart disease, 59 cases(13.9%); arrhythmia, 13 cases(3.0%); normal heart, 144 cases(33.6%). CONCLUSION: Among the patients referred to pediatric cardiology clinic, 33.6%(144 cases) had normal hearts and why these patient were referred may be possibly due to more dependence on echocardiography than on auscultation instruction. Threfore, clinical and auscultatory skill should be emphasized to minimize dependence on expensive echocardiography for evaluation of pediatric heart disease.

Citations

Citations to this article as recorded by

Evaluation and diagnostic approach for heart murmurs in children
Hee Joung Choi
Journal of the Korean Medical Association.2020; 63(7): 398. CrossRef

Clinical evaluation of pediatric hand injury.: Jeong Jin Kim, Jeong Cheol Kim, Dong Bo Suh, See Ho Choi, Jung Hyun Seul; Yeungnam Univ J Med. 1991;8(2):202-208. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.202

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Abstract PDF

Hand injury in children was increased due to multiple environmental risks and failed attention of parents to children in rapidly developing society. By the results of this evaluation in 37 cases, it was summarized as follows. First, hand injuries in children most commonly occurs in spring, and occurs more commonly in the children at the age of high activity. The most common level of injury is zone I by microreplantation zone, and zone II by tendon injury zone. The more desirable results were obtained by full thickness skin graft and composite graft if it were possible. For the better functional results compare to adults, the methods and procedures must be constructed after more evaluation with more clinical cases. In the cases of pediatric hand injury, the most important fact is prevention of injury, with the close attention by parents, and the second is appropriate diagnosis and treatment for more functional results.

Citations

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Difference in the epidemiologic and clinical characteristics by age groups of the children who visited a hand center emergency department with a hand injury requiring surgery
Donghun Kwak, Shindeuk Lee, Jinhyun Yoo, Hyunwoong Noh, Yunjun Kim, Insung Kim
Pediatric Emergency Medicine Journal.2016; 3(2): 53. CrossRef

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