Clinical Characteristics of Attention Deficit Hyperactivity Disorder in Childhood Malignant Hematologic Diseases / 대한소아신경학회지

PURPOSE: The purpose of this study is to identify the prevalence of attention-deficit hyperactivity disorder (ADHD) among children treated for childhood malignant hematologic diseases, and determine the different characteristics of the patients with ADHD as opposed to the patients without ADHD, which will help to predict the development of ADHD and to help treat them. METHODS: 172 patients diagnosed as childhood malignant hematologic diseases went through the test battery including diagnostic criteria for ADHD in pediatric neurology department of Seoul St. Mary's hospital from March 2009 to May 2012. Age, sex, ADHD type, hematologic diseases type, age at onset of hematologic diseases, treatment with/without chemotherapy and relapse were investigated. These data were compared between the groups of the patients without ADHD and with ADHD. RESULTS: Out of 172 patients, Fifty one patients (29.6%) had both ADHD and childhood malignant hematologic diseases. Sex (male), age at onset of hematologic diseases ( or =11 years (P=0.007). The patients with chemotherapy had about 3.4 fold increased risk for ADHD compared to the patients without chemotherapy (P=0.023). CONCLUSION: This study showed childhood malignant hematologic disorders has significant correlation with ADHD. In addition, Male, < or =5 years of age at onset and use of chemotherapy in the patients can be necessary to predict ADHD. Therefore, early detection and establishment of the countermeasures for ADHD are necessary.

Outcome of acute respiratory distress syndrome in children: a single center study

PURPOSE: This study aimed to determine the incidence, etiology, prognostic factors, and outcome of acute respiratory distress syndrome (ARDS) in children and to provide epidemiological data of children with ARDS treated at the pediatric intensive care unit (PICU) of a single center in Korea. METHODS: We conducted a retrospective medical chart review of 19 children diagnosed with ARDS at the PICU of The Catholic University of Korea, Seoul St. Mary's Hospital, between March 2009 and February 2012. RESULTS: Of the 334 PICU patients, 19 (5.6%) satisfied the American-European Consensus Conference definition of ARDS. Thirteen patients with ARDS died (mortality rate, 68.4%). Pneumonia was the most common cause of ARDS and observed in 10 patients (52.6%). There were significant differences between survivors and nonsurvivors in the PaO2/FiO2 ratio and the number of organ failure. The mortality rate was significantly higher in patients with a baseline PaO2/FiO2 ratio 100 mmHg (84.6% vs. 33.3%, P=0.046). We observed that a higher number of organ failure during the PICU stay, resulted in a higher mortality rate (P=0.037). Multiple logistic regression analysis showed that the PaO2/FiO2 ratio (adjusted odds ratio, 0.958) was independently associated with the increased risk of death after controlling for the number of organ failure. CONCLUSION: The mortality rate of ARDS in children was 68.4% in this study, a higher rate than those reported in other national and international studies. The PaO2/FiO2 ratio at the time of ARDS onset was a helpful prognostic factor for predicting the mortality rate of children with ARDS.