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Background Reliable assessment of asthma control is essential for effective treatment. While several validated tools for assessing asthma control in children are currently available, few studies have evaluated the correlations between different asthma control measures in children. This study aimed to determine the correlations between the Childhood Asthma Control Test (C-ACT) and the Global Initiative for Asthma (GINA) guideline-based asthma control measure (ACM) with lung function parameters in children with asthma. Methods Sixty-three children aged 6-11 years with mild-intermittent to severe-persistent asthma were evaluated. They completed the C-ACT, the GINA guideline-based assessment and lung function tests with the help of their caregivers. Results C-ACT scores and GINA guideline-based ACM were positively correlated. The average C-ACT scores for children with controlled, partly controlled and uncontrolled asthma according to the GINA guidelines were 24.4 ± 0.3, 22.8 ± 0.6 and 21.3 ± 1.0 (mean ± SE), respectively. High C-ACT scores were also noted in children with uncontrolled asthma based on the GINA guidelines. The GINA guideline-based ACM was correlated with spot spirometry parameters (forced vital capacity, forced expiratory volume in 1 second, and maximal mid-expiratory flow). Conversely, the C-ACT score was not correlated with these spirometry parameters. Conclusions The C-ACT may overestimate asthma control in certain circumstances. For children with poorly controlled asthma or poor symptom perception, more frequent visits and serial pulmonary function tests are recommended.

Background Congenital vocal cord paralysis (VCP) is a common cause of congenital stridor. Before the widespread application of flexible bronchoscopy (FB) by pediatricians, congenital stridor in infants was usually attributed to laryngomalacia. Prompt recognition and careful follow-up is crucial for the management of congenital VCP. Methods We performed a retrospective chart review of newborn infants with congenital VCP diagnosed by FB over a 12-year period. Results During the 12-year period, FB was performed on a total of 356 infants. Fifteen (4%) infants were diagnosed with congenital VCP. There were eight males and seven females and the mean age at diagnosis was 76.6 days. Stridor with respiratory distress was the most prominent presenting symptom. The majority (93%, 14/15) demonstrated bilateral VCP, while one patient (7%) had unilateral VCP. Seven of the 15 (46%) patients had idiopathic VCP, while eight (54%) had VCP associated with neuromuscular disorders. Tracheotomy was necessary in four patients (26%). None of them underwent further surgical interventions. Spontaneous recovery occurred in 10 patients (71%), and of these, 90% (9/10) were treated without tracheotomy. Conclusion In order to allow prompt diagnosis of congenital VCP, FB should be performed in every newborn infant with stridor. Patients with congenital VCP should undergo additional imaging studies to detect any associated neurological abnormalities and intrathoracic comorbidities. The majority of patients can be managed conservatively and monitored carefully using serial FB. Corrective surgery should be reserved for those with a lack of resolution at prolonged follow-up, and those with significant comorbidities.

Background Typhoid fever is caused by Salmonella enterica serotype Typhi ( S. typhi ). Growing communication between Taiwan and neighboring regions in recent years could be an important source of typhoid fever. The aim of this study was to analyze the clinical characteristics of typhoid fever treated at a medical center in southern Taiwan. Methods The study group consisted of 33 patients (aged 1–68 years) who had clinical symptoms and culture-confirmed typhoid fever. They were studied over a 20-year period from January 1987 to December 2006 at a tertiary referral hospital in southern Taiwan. Their medical records were reviewed and clinical data were collected. Results The study group included 17 males and 16 females. They were divided into two groups: group I (≤ 17 years; n = 14) and group II (> 17 years; n = 19). Only one patient (7.1%) in group I had a history of travel, compared with 47.4% ( n = 9) in group II ( p = 0.045). Patients in group I also had less chills (group I vs . group II=7.1% vs . 57.9%, p = 0.004). A higher proportion of group I patients had respiratory problems (cough, group I vs . group II=57.1% vs . 26.3%) and a higher proportion of group II patients developed complications (group I vs . group II=14.3% vs . 36.8%), but the differences were not significant. Conclusion Pediatric patients with typhoid fever in southern Taiwan had less history of travel and developed fewer chills than adult patients. Careful examination and familiarity with the clinical manifestations are important factors in the early diagnosis of typhoid fever.

Macrophage activation syndrome (MAS) is known to be a severe and potentially life-threatening complication of rheumatic disorder, especially systemic juvenille rheumatoid arthritis. It is very rare for MAS to be an initial presentation of systemic lupus erythematosus (SLE). Here, we report a 14-year-old girl in whom MAS developed as an initial presentation of SLE. With early diagnosis and administration of cyclosporine A, she had a fair outcome. Further testing showed positive anti-dsDNA about 8 months later.