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Background and Objectives: Positional therapy is a therapeutic method for obstructive sleep apnea (OSA). However, little is known about the effectiveness of positional OSA treatment based on meta-analysis. Therefore, we undertook a review and meta-analysis of studies to assess the effect of positional therapy on OSA. Subjects and Method: We searched PubMed (Medline), OVID Medline, EMBASE, Cochrane Library, SCOPUS, KoreaMed, MedRIC, and KSI KISS using the key words "obstructive sleep apnea" and "positional therapy". To estimate the effect of positional OSA therapy, we analyzed the ratio of means (ROM) for pre- and post-treatment polysomnographic data including apnea-hypopnea index (AHI), lowest oxygen saturation, arousal index, and sleep efficiency. Results: Finally, twenty two studies from 21 papers were included in the meta-analysis. Positional therapy significantly decreased AHI by 54.1% [ROM, 0.459; 95% confidence interval (CI), 0.394 to 0.534] and increased lowest oxygen saturation by 3.3% (ROM, 1.033; 95% CI, 1.020 to 1.046). However, positional therapy did not significantly change arousal index (ROM, 0.846; 95% CI, 0.662 to 1.081) or sleep efficiency (ROM, 1.008; 95% CI, 0.990 to 1.027). Conclusion: Positional therapy significantly improves respiratory parameters including AHI and lowest oxygen saturation in patients with OSA. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the clinical features and laboratory findings of enteroviral meningitis according to the presence of cerebrospinal fluid (CSF) pleocytosis, and to investigate the factors influencing pleocytosis in children. Methods: A retrospective study was conducted in 300 children with enteroviral meningitis confirmed by CSF reverse transcriptase polymerase chain reaction (RT-PCR) between 2012 and 2016. Electronic medical records including clinical and laboratory data were assessed. Clinical factors were compared between patients with and without pleocytosis. Results: Of the total 300 children with enteroviral meningitis, 73 had no pleocytosis. The proportion of infants under the age of two years was higher in patients without pleocytosis than in patients with pleocytosis (39.7% vs 14.5%, P <0.001). Patients without pleocytosis were younger (43.4 months vs 66.2 months, P <0.001), had less prevalence of headache and vomiting, lower peripheral white blood cell count (9,740±3,555/mm3 vs 11,632±3,872/mm3) and a shorter interval between the onset and lumbar puncture than those with pleocytosis. In multiple regression analysis, younger age, vomiting, lower white blood cell count, and interval less than 24 hours from onset to spinal tap were associated with the absence of pleocytosis. Conclusion: This study showed that children younger than two years of age had high proportion of absence of pleocytosis and some of the factors analyzed correlated with CSF inflammation. Therefore, absence of pleocytosis in the initial CSF sample cannot exclude meningitis, and rapid RT-PCR testing should be performed with high suspicion in young infants. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the clinical features and neurodevelopmental outcomes of white matter injury (WMI) using magnetic resonance diffusion-weighted imaging (DWI) in term neonates, associated with rotavirus infection. Methods: A retrospective study was conducted on 40 neonates with WMI admitted between January 2010 and December 2015. Eighteen patients (group I) had symmetrical periventricular WMI without cerebral cortical lesions on DWI. The other 22 patients (group II) had cortical lesions as well as WMI and were diagnosed with neonatal encephalopathy by specific causes. Results: Sixteen patients (88.9%) in group I tested positive for stool rotavirus antigen, whereas only 1 of 22 patients (4.5%) in group II tested positive. All patients in group I and eighteen patients (81.8%) in group II had seizures. Average seizure onset occurred at 4.7±1.0 days and 2.6±3.7 days in group I and II, respectively. Hypocalcemia was identified in 7 out of 18 patients in group I, but none in group II. Ten out of 12 patients (83.3%) in group I had normal developmental outcomes, but only 9 out of 16 patients (56.2%) in group II showed normal development between 6 and 26 months of age. Conclusion: Term neonates with WMI without cortical lesions on DWI had a high positive rate of rotavirus infection, but showed generally good neurodevelopmental outcomes. In this study, hypocalcemia was identified in some patients with WMI associated with rotavirus infection, but the pathomechanism for this was unclear. Therefore, further research will be necessary. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the clinical features of neonatal seizures and to identify prognostic factors of neurodevelopmental outcome in term infants who experienced clinical seizures. Methods: A retrospective analysis was performed on 153full term and preterm infants with seizures from January 2008 to December 2013. Binary logistic regression analysis was applied to assess risk factors associated with neurological adverse outcomes using variables that were found to be significant on univariate analysis. Results: During the study period, 102 (66.7%) term and 51 (33.3%) preterminfants were enrolled. The main cause of neonatal seizures was hypoxic ischemic encephalopathy (24.5%) in term infants and intracranial hemorrhage (74.5%) in preterm infants. The most common type of seizure was focal clonic seizure. Generalized tonic seizure was more commonly observed in preterm than in term infants. 39 out of 56 term infants with at least 12 months of neurologic followup showed normal outcomes while only one preterm infant showed normal development. Prognostic factors related to adverse neurodevelopmental outcomes in term infants were perinatal history of fetal distress, etiology of hypoxic ischemic encephalopathy, severity of EEG(Electroencephalogram) abnormality, evidence of hypoxic ischemic encephalopathy on brain magnetic resonance imaging, and the need for multiple antiepileptic drugs for seizure control. Conclusion: Preterm infants showed poorer neurodevelopmental outcomes compared to term infants. The etiology of seizures, treatment response, neuroimaging and electroencephalographic findings were important in predicting the developmental outcome in term infants with seizures. [ABSTRACT FROM AUTHOR]