Three cases in which drug-induced hyponatremia was improved by replacing carbamazepine with lacosamide.

Carbamazepine often causes drug-induced hyponatremia. Hyponatremia due to carbamazepine may be improved by changing to the same mechanism of action, lacosamide.

Assessment of oxidative stress in autism spectrum disorder using reactive oxygen metabolites and biological antioxidant potential.

There are several studies on oxidative stress of Autism Spectrum Disorder (ASD), but in these cases there is no study to measure oxidative stress and antioxidant capacity at the same time or studies considering childhood development. Therefore, this study comprehensively assessed the level of oxidative stress in ASD children by simultaneously measuring reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP). The subjects were Japanese, 77 typical development (TD) children, 98 ASD children, samples were plasma. The subjects were divided into age groups: toddlers/preschool age (2-6 years) and school age (7-15 years), to compare the relationships among the d-ROMs levels and BAP/d-ROMs ratios. Furthermore, the correlations between the Parent-interview ASD Rating Scales (PARS) scores and the measured values were analyzed. The levels of d-ROMs were significantly higher in the ASD (7-15 years) than in TD (7-15 years). The PARS scores were significantly higher in the ASD and were significantly correlated with d-ROMs levels. These results suggested that d-ROMs and BAP/d-ROMs ratios could be objective, measured indicators that could be used in clinical practice to assess stress in ASD children.

Evaluation of the efficacy of drug treatment based on measurement of the oxidative stress, using reactive oxygen metabolites and biological antioxidant potential, in children with autism spectrum disorder and attention deficit hyperactivity disorder.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disorder, mainly characterized by impairment of social communication and restricted interests. ASD is frequently accompanied by attention deficit hyperactivity disorder (ADHD), which is characterized by carelessness, hyperactivity and impulsivity (ASD/ADHD). It has been suggested that ASD and ADHD are associated with oxidative stress, that is, that patients with ASD/ADHD are in a state of increased oxidative stress. There are currenr tly no objective or biological test criteria for evaluating the efficacy of drug therapy in these patients. The purpose of this study was to evaluate whether oxidative stress markers [serum reactive oxygen metabolites (d-ROMs) levels and biological antioxidant potential (BAP)] can be used as objective indicators for evaluating the efficacy of drug treatment in ASD/ADHD patients. METHODS: The subjects of this study subjects were 50 Japanese patients with ASD/ADHD aged 4 to 14 years old. Serum samples were obtained from the patients to measure the serum levels of d-ROMs and the serum BAP. The study subjects were divided into two age groups: preschool children (4 to 6 years old) and school-age children (7 to 14 years old), and the serum levels of d-ROMs, serum BAP, serum BAP/d-ROMs ratio (hereinafter, the prefix serum will be dropped), and scores on the Parent-interview ASD Rating Scales-Text Revision (PARS-TR) and ADHD Rating Scale (ADHD-RS) were determined before and after drug therapy and compared between the two groups. In addition, changes in the d-ROMs, BAP and BAP/d-ROMs ratio and changes in the scores on the PARS-TR and ADHD-RS after treatment were also analyzed. RESULTS: Significant decrease of the d-ROMs, BAP, and scores on the PARS-TR and ADHD-RS, with a significant increase of the BAP/d-ROMs ratio, was observed after treatment. In addition, a significant correlation was observed between the changes in the d-ROMs and changes in the scores on the PARS-TR and ADHD-RS after treatment in the school-age ASD/ADHD children. CONCLUSION: Our results suggest the possibility that the serum level of d-ROMs may be useful as an objective assessment marker to supplement the subjective assessment of the effects of drug treatment in school-age children with ASD/ADHD.

Recurrent Staphylococcus aureus abscess and fatal pneumococcal septicemia due to IRAK-4 deficiency.

We describe the case of an infant with recurrent episodes of staphylococcal skin abscess and subsequent lethal pneumococcal meningitis/septicemia due to interleukin-1 receptor-associated kinase 4 (IRAK-4) deficiency. In this case, systemic signs of inflammatory response were poor and delayed. Among all other reported cases of IRAK-4 deficiency, none involved severe viral or fungal disease, and the range of infecting bacteria was narrow.

[An approach to prevent lifestyle-related diseases of children in collaboration with various organizations in Tokushima].

OBJECTIVE: To support the goal of "Lifetime health promotion from childhood", a Committee for Strategies to Prevent Lifestyle-related Diseases was established as part of the Tokushima Prefecture Medical Association in 2000. In this report, we present the activities of this committee, in collaboration with various organizations such as schools, a medical association, health administrators and universities. ACTIVITIES: In 2000, a physical survey was performed for all students in primary and junior high schools in Tokushima prefecture. Subsequently, a software program for determining the degree of obesity using the standard body weight of Tokushima children was produced. In 2001, the committee conducted a survey concerning measures taken against lifestyle-related diseases by each organization. In 2003, a "Health management system for obesity in children" and a "School urine examination system" were established to identify high-risk students who should be taken to consult primary physicians. These medical intervention systems have allowed continuous calculation of real numbers and actual status of problems with overweight and obese children. Moreover, we performed lifestyle habit surveys among about 3000 students and produced manuals for population-based approaches. RESULTS: Compared with nationwide values, there was no difference in height, but the weight and BMI (Body Mass Index) of Tokushima students were larger. The survey concerning measures against lifestyle-related diseases clarified the present status of school health committees, staffing available to provide individual/nutritional guidance and the execution rate of collaborative projects in each organization. The intervention systems for visits to primary physicians have continued to show almost constant consultation rates. Approximately 80% of severely obese children had at least one medical problem. The lifestyle habits survey did not identify any marked differences in children of Tokushima Prefecture compared with nationwide values, except for a slightly earlier waking-up time. However, this survey demonstrated differences in lifestyle habits according to the body physique, and a relationship between eating meals with the family and other lifestyle habits. The numbers of overweight and severely obese children in Tokushima have been decreasing since the peaks of 2001 and 2002. CONCLUSIONS: Activities to prevent lifestyle-related diseases from childhood have continued in collaboration with various organizations in Tokushima. The prefecture-wide physical surveys and high-risk intervention strategies might have had good social effects in Tokushima. As a result, the number of obese children may be decreasing.

Prevalence of metabolic complications in children with severe obesity.

BACKGROUND: The purpose of the present paper was to clarify the prevalence of metabolic complications in severely obese children. METHODS: The subjects of the present study were 367 severely obese Japanese children in Tokushima, who were more than 150% of the standard weight for their sex and height (school grades 1-9; age range, 6-16 years). Data concerning anthropometric and metabolic parameters (body fat %, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, uric acid, blood glucose, serum insulin, alanine aminotransferase, and blood pressure) were analyzed. RESULTS: The prevalence of each abnormality in obese children was high compared with that in the general population. Metabolic variables were correlated with each other. A total of 80.4% of severely obese children had at least one complication. CONCLUSION: Severely obese children have various metabolic abnormalities even during their early school years. Intervention by primary physicians in cooperation with schools is needed for the prevention of lifestyle-related diseases.

A case of Japanese spotted fever complicated with acute myocarditis.

Japanese spotted fever (JSF) is caused by Rickettsia japonica. Although it induces a variety of complications, acute myocarditis has never been reported as a complication of JSF. We treated a JSF patient who developed acute myocarditis. To our knowledge, this is the first case of JSF complicated with acute myocarditis.