Ayumi Okada

Analysis of the synthetic house-tree-person drawing test for developmental disorder.

Some patients cannot draw three subjects on the same page during the synthetic house‐tree‐person drawing test (S‐HTP). We call this phenomenon “no synthetic sign”. The aim of this study was to clarify the pathological meaning of no synthetic sign and investigate its use for the early detection of developmental disorders at a pediatric primary care center.

Recurrent apnea in an infant with pertussis due to household transmission

Bordetella pertussis causes life‐threatening apnea in infants. Lymphocytosis is an important clue for diagnosis and for determining the severity of pertussis. Antibiotics do not shorten or ameliorate the disease and only decrease the risk of transmission. Antepartum maternal immunization is important for preventing pertussis in infants.

Development of a Japanese scale for assessment of paediatric normal weight.

The Broselow tape (BT) system has helped health care profesionals succeed in avoiding errors made in paediatric acute care.1 lthough the BT has been used worldwide, it is not surprising that his American-based scale has limited applicability to paediatric opulations outside of the United States.2,3 We therefore aimed o develop a length-based weight estimation scale for Japanese hildren, the Japanese Paediatric Assessment of Normal weight JAPAN) scale. We used data of participants in a large, ongoing ongitudinal survey conducted in Japan (the Longitudinal Survey f Babies in the 21st Century4), to achieve better performance of he JAPAN scale. We also described our method of developing the cale. We obtained 370,980 measurements of body weight and height rom 39,547 participants 12–155 months old. We created the APAN scale using 75% of measurements, randomly selected from he total using the Stata random-number function binomial. We alculated and listed means of weight (kg) and the number of amples according to height, ranging from 45 cm to 179 cm, in n integral format. We then linked weight with height, begining with a height of 72 cm, with more than 100 measurements. p to 19 kg, we rounded means of weight to whole numbers and hecked the corresponding heights. For weights between 19 kg nd 36 kg, we considered the means of weights 19.5–20.9 kg to e 20 kg, those of 21.0–22.9 kg to be 22 kg, and so on up to 6 kg, and checked the corresponding heights. To check validity f the scale compared with the BT (2007 and 2011 versions), we pplied the three scales to the remaining 25% of measurements nd calculated mean absolute error as well as root mean square rror (RMSE) for each scale.5 Stata Statistical Software Release 13 StataCorp LP, College Station, TX, USA) was used for all analyes. The relationship between weight and ranges of height for the APAN scale is shown in Table 1. The newly developed JAPAN scale erformed better than the 2007 and 2011 versions of the BT. For the APAN scale vs. the BT 2007 vs. the BT 2011, mean absolute error kg) was 1.79 vs. 1.85 vs. 1.91, and RMSE (kg) was 2.77 vs. 2.92 vs. .80, respectively. Considering that the JAPAN scale was developed based on a apanese paediatric population and performed best for Japanese hildren, each country should develop a similar weight estimation cale for its own paediatric population, using available anthroometric data. Because of changing paediatric growth patterns ithin each country, these weight estimation methods should be pdated or re-evaluated regularly. Use of an appropriate scale in an 4

Birth order and paediatric allergic disease: A nationwide longitudinal survey

Environmental factors seem to be related to the incidence of allergic disease. Children with a later birth order are often exposed to environments, where pathogens and endotoxins can be found, and thus have a higher risk of developing infectious diseases. Therefore, birth order is regarded as an indicator that reflects post‐natal environment. However, longitudinal studies are limited on this subject. This study sought to elucidate the relationships between birth order and allergic disease.

New age‐based weight estimation formulae for Japanese children

Although dosing and sizing of resuscitation drugs and equipment are mostly weight based, time is usually insufficient to weigh critically ill children. Many age‐based weight estimation formulae for emergency use have been developed worldwide, but there is no specific formula for Japanese children. The aim of this study was therefore to develop and validate age‐based formulae for estimating the bodyweight of children living in Japan.

Neonatal-Onset Hereditary Coproporphyria: A New Variant of Hereditary Coproporphyria

Genetic mutation of the coproporphyrinogen oxidase (CPOX) gene causes either hereditary coproporphyria (HCP) or harderoporphyria. HCP, a rare hepatic porphyria, causes acute attacks after puberty and rarely accompanies cutaneous symptoms. In contrast, harderoporphyria is an erythropoietic porphyria that represents photosensitivity and hemolytic anemia from the neonatal period. In patients with harderoporphyria, the p.Lys404Glu mutation is found in the homozygous or compound heterozygous state with another mutation, and a marked increase in harderoporphyrin is observed. This report describes a neonate with symptoms of erythropoietic harderoporphyria (photosensitivity of the skin, hemolytic anemia, and jaundice). However, the pattern of porphyrin metabolites of feces was consistent with that of typical HCP, not of harderoporphyria. We found a heterozygous, novel, four-base pair deletion in exon 7 of the CPOX gene, although other mutations including the p.Lys404Glu mutation in CPOX were not found. By unknown etiology, our patient had accompanying adrenocortical insufficiency and 46, XY disorders of sex development. Based on genetic mutation of the CPOX gene and information from a previous similar case report, we consider that neonatal-onset HCP is a variant of HCP.