β2 microglobulin and lactate dehydrogenase are indices of different features of Mycoplasma pneumoniae-associated community-acquired lower respiratory tract infection for severity evaluation in children.

Using the hospital records, we retrospectively assessed whether urinary β2 microglobulin/creatinine ratio (UBCR) and lactate dehydrogenase (LD) values could be used to estimate the severity of Mycoplasma pneumoniae-associated lower respiratory tract infection (MP-LRTI). We studied 48 patients with MP-LRTI (median age, 7.5 years; range, 3-14 years) admitted to Kagoshima City Hospital and examined the relationships of the UBCR or LD values with fever and pulmonary tissue damage (hypoxemia and severity assessments on chest radiographs).

Two siblings with very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency suffered from rhabdomyolysis after l-carnitine supplementation.

Introduction: Very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency is an autosomal recessive mitochondrial fatty acid oxidation disorder and presents as hypoketotic hypoglycemia or rhabdomyolysis during childhood. l-Carnitine supplementation for patients with VLCAD deficiency is controversial. Herein, we describe two siblings with VLCAD deficiency who experienced more frequent episodes of rhabdomyolysis after l-carnitine supplementation.

Open-label clinical trial of bezafibrate treatment in patients with fatty acid oxidation disorders in Japan.

Introduction: Fatty acid oxidation disorders (FAODs) are rare diseases caused by defects in mitochondrial fatty acid oxidation (FAO) enzymes. While the efficacy of bezafibrate, a peroxisome proliferator-activated receptor agonist, on the FAO capacity has been reported, the efficacy remains controversial. Therefore, we conducted a clinical trial of bezafibrate in Japanese patients with FAODs.

Adipokines and the prediction of the accumulation of cardiovascular risk factors or the presence of metabolic syndrome in elementary school children.

Background: Information is limited about how adipokines predict the accumulation of cardiovascular (CV) risk factors or the presence of metabolic syndrome (MS) in children.

Methods And Results: The subjects were 321 children (200 boys and 121 girls; 109 normal and 212 obese) aged 6-12 years. Obesity was defined as a body mass index of >or= the 95(th) percentile for age and sex.

Association between the number of cardiovascular risk factors and each risk factor level in elementary school children.

Background: Little is known regarding the association between numbers of cardiovascular (CV) risk factors and the level of each risk factor in elementary school children based on a longitudinal study.

Methods And Results: A descriptive study of 319 obese children aged 6-11 years who participated in a screening program for comorbidity of obesity between 2003 and 2005, and who participated in consecutive years thereafter, was performed. Abdominal obesity, hypertension, dyslipidemia (low high-density lipoprotein-cholesterol levels and/or high triglyceride levels), and raised fasting glucose levels were used as the CV risk factors.

Early diagnosis of Kawasaki disease in patients with cervical lymphadenopathy.

Background: Among typical patients with Kawasaki disease (KD), a few KD patients present with only fever and cervical lymphadenopathy at admission (KDL). These patients have a significant risk for misdiagnosis, delay in treatment for KD, and development of coronary artery abnormalities. Therefore, the development of an easy tool for early diagnosis in these patients is desirable.

Metabolic syndrome in overweight and obese Japanese children.

Objective: To determine the prevalence of and sex differences related to the metabolic syndrome among obese and overweight elementary school children.

Research Methods And Procedures: Subjects were 471 overweight or obese Japanese children. Children meeting at least three of the following five criteria qualified as having the metabolic syndrome: abdominal obesity, elevated blood pressure, low high-density lipoprotein-cholesterol levels, high triglyceride levels, and high fasting glucose levels.

Predictive factors in the success of intervention to treat obesity in elementary school children.

Background: Currently, a generalizable conclusion on the effectiveness of treatment programs for childhood obesity cannot be drawn, and how practical and effective the intervention strategies are remains a controversial subject.

Methods And Results: In the present study 36 obese elementary school children who visited an intervention program at least 4 times were followed for 12 months or more. A stepwise regression analysis was performed using the decrease in the percent relative body weight (%RBW) at 12 months after the first visit as a dependent variable, and the decrease in the %RBW and nutritional data between 2 successive visits as independent variables.

Prevention of mildly overweight children from development of more overweight condition.

Background: A follow-up study has reported that not only highly obese but also mildly obese children are becoming heavier during the elementary school children. Then we determined the effect of programs for the screening and treatment of overweight elementary school children whether the programs prevented mildly overweight children from development of more overweight condition.

Methods: Subjects were 40 overweight children who participated in both screening and treatment programs.

Patients diagnosed with Kawasaki disease before the fifth day of illness have a higher risk of coronary artery aneurysm.

Background: A fever lasting for at least 5 days is an essential characteristic of the original diagnostic criteria of Kawasaki disease (KD). However, it is not difficult for an experienced physician to confirm the diagnosis of KD before the fifth day of fever. The aim of this study is to investigate the effect of intravenous gamma globulin therapy (IVGG) in KD initiated before the fifth day of illness.