• Title/Summary/Keyword: child hypertension

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Renal and Renovascular Hypertension in Children (소아의 신성 고혈압)

  • Hahn, Hye-Won
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.1-13
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    • 2011
  • Hypertension is a major risk factor of atherosclerosis which results in cardiovascular disease, and remains a major health problem worldwide. While children are more likely to have secondary hypertension, recent studies support the theory that the prevalence of essential hypertension in children and adolescents is increasing with the global epidemic of childhood obesity, and close attention is needed. Evaluation of hypertension in the pediatric age group should be guided by the age at presentation, and renal diseases must be considered in every child with hypertension, because of the prevalence of renovascular and renal parenchymal disorders as the etiology in any age group. The majority of children with chronic kidney disease are hypertensive, and many have associated end organ damage. Thus, once hypertension has been confirmed, end organ care as well as pharmacologic therapy must be continued. In renovascular hypertension, as cure could be gained with surgical/endovascular intervention, accurate diagnosis is important and it is recommended that every suspected child should undergo angiography.

Accessory Hepatic Lobe: A Rare Cause of Prehepatic Portal Hypertension in a Child

  • Sag, Elif;Cansu, Aysegul;Imamoglu, Mustafa;Cakir, Murat
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.4
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    • pp.361-364
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    • 2018
  • Accessory hepatic lobe is noted as and considered a rare disease in children. It can manifest with various symptoms and complications depending on the location, volume, type and position of the disease as presented on a child. The patient presented as a 14-month-old girl who was seen with a notable hepatosplenomegaly and portal hypertension. A diagnosis was made after taking an extensive medical history, observation and radiological examinations. The formal diagnosis was a prehepatic portal hypertension associated with accessory hepatic lobe.

Tumor Recurrence in Hepatocellular Carcinoma Patients after Radiofrequency Ablation: Portal Hypertension as an Indicator of Recurrence of Hepatocellular Carcinoma (간세포암 환자의 고주파열치료 후 종양 재발: 예후인자로서 문맥고혈압)

  • Jang, Seong Won;Cho, Yun Ku;Kim, Ju Won;Gil, Je Ryung;Kim, Mi Young;Lee, Young
    • Journal of the Korean Society of Radiology
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    • v.79 no.5
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    • pp.264-270
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    • 2018
  • Purpose: To evaluate the effect of portal hypertension on the tumor recurrence in patients with hepatocellular carcinoma (HCC) and without hepatic decompression following radiofrequency ablation (RFA). Materials and Methods: Treatment-naïve HCC patients within the Milan criteria and with Child-Pugh class A were included in this study, who had performed RFA in our hospital between January 2010 and March 2017. Univariate and multivariate analyses using the Cox proportional hazard model were performed to find the predictors of local or distant tumor recurrence. Results: Overall, 178 patients were included in this study. Median follow-up period was 40.2 months. The difference in the local tumor progression rates depending on the absence or presence of portal hypertension was not statistically significant (p = 0.195). The 1-, 3-, and 5-year distant intrahepatic tumor spread rates were 6.6%, 29.5%, and 537% in patients without portal hypertension, and 23.4%, 51.9%, and 63.6% in patients with portal hypertension, respectively. The difference was statistically significant (p = 0.011). Univariate and multivariate analysis showed that portal hypertension was an independent predictor for distant intrahepatic tumor spread (p = 0.008). Conclusion: For HCC patients with Child-Pugh class A, portal hypertension adversely affected distant intrahepatic tumor progression.

Portal Hypertension of a Delayed Onset Following Liver Abscesses in a 12-Month-Old Infant: A Case Report and Review of the Literature

  • Al-Qurashi, Faisal Othman;Aladsani, Ahmed Abdullah;Qanea, Fatema Khalil Al;Faisal, Sarah Yousef
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.4
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    • pp.400-406
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    • 2019
  • We report a 12-month-old female infant who had a history of neonatal sepsis with liver micro-abscesses that resolved with intravenous antibiotics during neonatal period. During her neonatal admission period, no umbilical vein catheter was inserted. Also, she did not undergo any abdominal surgeries or had a postnatal history of necrotizing enterocolitis. However, the child developed upper gastrointestinal bleeding in form of hematemesis and melena secondary to esophageal varices at the age of 12 months with an extra-hepatic portal vein obstruction with cavernous transformation and portal hypertension subsequently. The child underwent a successful endoscopic injection sclerotherapy. She is now 20-month-old and has portal hypertension but otherwise asymptomatic. We are proposing the possibility of a delayed-onset portal hypertension as a complication of liver abscess and neonatal sepsis.

Prevalences of Hypertension and Obesity of Children in Kangnung (강릉지역 국민학생의 고혈압 및 비만의 이환율에 관한 연구)

  • 김현아
    • Journal of Nutrition and Health
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    • v.27 no.5
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    • pp.460-472
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    • 1994
  • Prevalences of hypertension and obesity of primary school children in Kangnung were investigated, and the correlations between blood perssure and measured anthropometry were also studied to identify the factors that influence on blood pressure. 1,164 children (602 boys and 562 girls) from five elementary schools were chosen for this study. Anthropometric measurements were taken for blood pressure, body weight, height, triceps skinfold, and circumferences of chest and arm. Data of family history of hypertension were obtained by means of prepared questionnaires. Prevalences of hypertension were 3.3% in boys and 3.1% in girls. The group with elevated blood pressure had relatively a greater frequency of familial hypertension and significantly higher mean body weight and obesity index. The prevalence of obesity was defined as percentage of children whose rates of current weight to standard weight for height and sex in Korean children were more than 120%. Prevalence of obesity were 16.3% in boys, 10.3% in girls. There findings clearly revealed the influences of above-average weight and familial hypertension on blood pressure. These results suggest that children with familial hypertension should be avoid excess adiposity and be measured blood pressure regularly.

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Comparative Analysis of American Academy of Pediatrics and European Society of Hypertension Guidelines for the Diagnosis and Treatment of Pediatric Hypertension

  • Park, Se Jin;Shin, Jae Il
    • Childhood Kidney Diseases
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    • v.25 no.2
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    • pp.71-77
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    • 2021
  • Childhood hypertension (HTN) has become a significant public health issue because of the increased risk of cardiovascular disease in adulthood. However, childhood HTN is underrecognized and underdiagnosed in clinical practice. The European Society of Hypertension in 2016 and the American Academy of Pediatrics (AAP) in 2017 published updated guidelines for the screening, prevention, and management of pediatric HTN. There were notable differences between the two guidelines as well as many similarities. The updated AAP guidelines have clarified and simplified the recommendations for screening, diagnosis, and treatment of childhood HTN based on current evidence. This review highlights the important developments in both guidelines, focusing on recent advances in the classification and treatment of childhood HTN.

Effect of Nifedipine in Acute Episode of Postoperative Pulmonary Hypertension and Right Heart Failure (심장 수술후에 발생한 급성 폐동맥 고혈압및 우심부전증 환자에서 nifedipine의 효과)

  • Choe, Sun-Ho;Choe, Jong-Beom;Yun, Hyang-Seok
    • Journal of Chest Surgery
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    • v.25 no.7
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    • pp.736-738
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    • 1992
  • We report the successful use of Nifedipine in the treatment of acute pulmonary hypertension in an young child after a cardiac operation. This patient had undergone patch closure of large ventricular septal defect. She had signs of severe pulmonary artery hypertension unresponsive to hyperventilation, oxygenation, sedation, and a myriad of vas-oactive drugs. Nifedipine, 0.3mg /kg every 4 hours, effectively treated her pulmonary artery hypertension and allowed for a smooth postoperative course and positive outcome. The drug lowered systemic diastolic pressure, but not systolic pressure.

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Pathogenetic Overlapping of Renovascular Hypertension Developed in a Child with Takayasu Arteritis: 'One-clip, One and Half-kidney Model'

  • Lee, Su Jeong;Baek, Hee Sun;Jang, Hea Min;Kim, Hyung-Kee;Huh, Seung;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.20 no.1
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    • pp.33-36
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    • 2016
  • There are two pathogenic models of renovascular hypertension (RVH) originating from renal artery stenosis. We noted a case of a boy who had severe hypertension with atrophic left kidney, hypertrophic right kidney, a segmental stricture of the abdominal aorta, and total occlusion of the right renal artery. Due to the atrophic change of the contralateral, unclipped left kidney, this patient presented with various clinical manifestations related to both models of pathogenesis of RVH occurring at the same time. We conclude that this patient presented with the middle stage of the two RVH pathogenetic models, so called the 'one-clip, one and half-kidney model.'

Pulmonary hypertension due to obstructive sleep apnea in a child with Rubinstein-Taybi syndrome

  • Choi, Hyung Soon;Yu, Jeong Jin;Kim, Young-Hwue;Ko, Jae-Kon;Park, In-Sook
    • Clinical and Experimental Pediatrics
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    • v.55 no.6
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    • pp.212-214
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    • 2012
  • Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our case, pulmonary hypertension was caused, successively, by congenital heart defects (a large patent ductus arteriosus and arch hypoplasia) and obstructive sleep apnea during early infancy. The congenital heart defects were surgically corrected, but persistent pulmonary hypertension was identified 2 months after the operation. This pulmonary hypertension was due to OSA, and it was relieved by nasal continuous positive airway pressure. This case is the first report of pulmonary hypertension from OSA in a young infant with RTS.

A study on proper dosage of Ma-huang(麻黃) (마황(麻黃)의 적정 용량에 대한 고찰(考察))

  • Ryu, Hee-chang;Shin, Jeong-gyu
    • 대한상한금궤의학회지
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    • v.5 no.1
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    • pp.101-111
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    • 2013
  • Objective : The purpose of this study is to find out the proper dosage of Ma-huang for clinical use of Shanghanlun(傷寒論) Methods : To achive the purpose of this study, web-databases(pubmed, naver, google) were searched with the keywords including 'dose of Ma-huang Ephedra Ephedrine','dosage of Ma-huang Ephedra Ephedrine', and 'water extract of Ma-huang Ephedra'. The searched 30 papers and articles were reviewed. Results & Conclusions : 1. Proper dosage of Ma-huang 1) Adult: up to 9-12g/day 2) Adolescent: up to 6g/day 3) Hypertension disorder patient: up to 6g/day 4) lactating women: up to 6g/day 5) child: <2 years 0.7-2.5g/day, $${\geq_-}2$$ years 2.6-6g/day (Different from body weight) Although administration of Ma-huang to hypertension disorder patient, lactating women, child is safe on the paper, It is not recommended to these people because Ma-huang is one of toxic herbs. 2. Dosage form of Ma-huang There's no safety paper about pill or powdered Ma-huang(麻黃). There's not pill or powdered prescription of Ma-hunag in Shanghanlun(傷寒論), either. So it is recommended to administrate water exetract of Ma-huang.