Pediatric thalassemic patients have higher incidence of asthma: A nationwide population-based retrospective cohort study.

INTRODUCTION: Patients with hemoglobinopathies have been reported to have higher rates of pulmonary complications. Few studies have investigated the association between thalassemia and asthma in children. METHODS: We used the data of one million individuals randomly selected from the Registry for Beneficiaries of the National Health Insurance Research Database. One thalassemic child was matched with four control children without thalassemia according to sex, birth year, birth season, prematurity, and previous enteroviral infection. RESULTS: A total of 800 hundred thalassemic children and 3200 controls were included. Children with thalassemia had higher rates of developing asthma (41.81 vs 25.70 per 1000 person-years, P < 0.001) than the non-thalassemia controls with an adjusted hazard ratio of 1.37 (95% confidence interval [CI] = 1.19-1.58). Boys in the thalassemia cohort had a significantly higher adjusted incidence hazard ratio (IRR) of asthma than those in the non-thalassemia cohort (adjusted IRR = 1.45, 95% CI = 1.02-1.73). The risk of atopic and nonatopic asthma was higher in the thalassemia cohort than in the non-thalassemia cohort (IRR = 1.3, 1.61, respectively). CONCLUSIONS: Children with thalassemia were more likely to develop asthma. More attention should be paid to the early diagnosis of asthma and prevention of asthma attacks.

Diagnostic values of C-reactive protein and complete blood cell to identify invasive bacterial infection in young febrile infants.

BACKGROUND: Newborn infants younger than 3 months old with a fever are frequently evaluated for the risk of invasive bacterial infections (IBIs), which include bacteremia and/or bacterial meningitis, in the pediatric emergency department (PED). The purpose of this study was to determine the individual complete blood cell count and biochemistry levels associated with IBIs in febrile infants. METHODS: We carried out this retrospective study using a pediatric emergency department at a tertiary medical center in southern Taiwan, where we also evaluated the clinical characteristics and routine blood tests between experimental groups. RESULTS: We enrolled 1231 febrile infants under the age of 3 months old in this study. We found higher body temperature, neutrophil percentage, and C-Reactive protein (CRP) values and a lower hemoglobin level in the IBIs group. Furthermore, a CRP value greater than 25 mg/L can predict IBIs at a better rate than the group with values lower than 25 mg/L (11.7% vs. 2.1%, Odds ratio 6.3, p < 0.001). CONCLUSION: This study provides evidence that a CRP level greater than 25 mg/L can more accurately predict IBIs in febrile infants. Furthermore, lower hemoglobin levels were also found in IBIs. Nevertheless, additional laboratory tests are needed to identify young febrile infants with IBIs.

Congenital central hypoventilation syndrome in a full-term baby presenting with repeated extubation failure.

Congenital central hypoventilation syndrome (CCHS) is a rare condition. The main characteristic is respiratory insufficiency during sleep. Patients who have CCHS need varying degrees of ventilation support during sleep, or even all day long, according to its severity. We report a term baby with repeated extubation failure, CCHS and Hirschsprung's disease diagnosed at 1 month of age. This patient was discharged at 5 months old with a home ventilator and reached normal developmental milestones.