Itaru Terashima

Chibaken Saiseikai Narashino Hospital , Tiba, Chiba, Japan

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Publications (3)6.91 Total impact

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    ABSTRACT: The purpose of the study is to evaluate the incidence, spectrum of clinical manifestations and outcome of invasive pneumococcal disease (IPD) in children in Chiba prefecture, Japan. To determine the precise incidence of IPD in Chiba prefecture, we implemented a retrospective survey of the period from 2003 to 2005. A written questionnaire was sent to 45 hospitals that have pediatric wards, and information was obtained from all hospitals. The questionnaire included the clinical diagnosis, patient's age, underlying disease, prognosis and antimicrobial susceptibility of the isolated strains. During the 3 study years, 130 patients were diagnosed with IPD. The mean annual incidence rates of IPD among children <2 and <5 years were 19.5-23.8 and 12.6-13.8 per 100,000, respectively. Among 130 patients with systemic infection, 66 patients had bacteremia, 39 had pneumonia and 16 had meningitis. Five patients had neurological sequelae and 2 patients died. Seventy-four out of 115 isolates (64.3%) exhibited resistance to penicillin G. The annual incidence of pediatric IPD has remained constant during the study period. Two-third of isolated strains were at least partially resistant to penicillin G. Establishment of appropriate antibiotic therapy against IPD due to penicillin-resistant strains and the introduction of pneumococcal conjugate vaccines are emergent issues in Japan.
    The Journal of infection 10/2008; 57(6):455-8. · 4.13 Impact Factor
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    ABSTRACT: In pediatrics, the offending microorganisms in lower respiratory infections have not yet been established. Our data based on 1,898 patients with lower respiratory tract disorders in children (1965–1979) demonstrated that washed sputum is of practical value in establishing the etiological diagnosis of bronchopulmonary infections in children. The criteria for the determination of the dominant or offending pathogens are presented.H. influenzae was found to be the leading organism, especially in patients having a recurrent or protracted course: its incidence was 64.1% in chronic bronchitis, 24.5% in recurrent or protracted bronchitis, 21.7% in pneumonia and 15.0% in acute bronchitis. H. influenzae seemed most significant in aggravating the signs and symptoms accompanying the infection. Recent bacteriological study of washed sputum (1980–1981) revealed an increasing frequency of H. influenzae as a causative agent.Ampicillin-resistant H. influenzae strains have been demonstrated since 1976, and constituted 13.5% of 154 strains, while chloramphenicol-resistant strains remained at 2.5% in 1982. The biotypes of ampicillin-sensitive and resistant strains included not only types I and II but types III to v.
    Pediatrics International 10/2007; 27(1):94 - 101. · 0.88 Impact Factor
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    ABSTRACT: We studied the effects of a new regimen consisting of intravenous immune globulin (IVIG) combined with dexamethasone (DEX) on clinical outcome and serum levels of vascular endothelial growth factor (VEGF) in the initial treatment of Kawasaki disease (KD). A total of 46 KD patients received 0.3 mg/kg per day DEX plus heparin i.v. for 3 consecutive days, together with 2 g/kg IVIG over 4 to 5 days (DEX group). Low-dose acetylsalicylic acid was started after completion of DEX therapy. The control group consisted of 46 KD patients retrospectively treated earlier with 2 g/kg IVIG over 4 to 5 days plus higher dose acetylsalicylic acid (CONTROL group). No serious adverse effect was noted in either group. There were no differences in baseline and post-treatment laboratory data except for C-reactive protein between the groups. Post-treatment C-reactive protein in the DEX group (median 0.9 mg/dl, range 0.0 to 24.7 mg/dl) was lower than that (1.2 mg/dl, range 0.2 to 19.5 mg/dl) in the CONTROL group ( P=0.033 by Mann-Whitney U test). In addition, the mean duration of fever after the first IVIG infusion was 2.2 days (median 1 day, range 1 to 12 days) in the DEX group and 2.8 days (2 days, 1 to 16 days) in the CONTROL group ( P=0.015 by Mann-Whitney U test). The new regimen did not reduce VEGF levels. Two patients in each group developed small- or medium-sized coronary artery aneurysms. CONCLUSION: Although this regimen did not affect coronary outcome, intravenous immune globulin therapy combined with dexamethasone for the initial treatment of Kawasaki disease was safe and may accelerate the resolution of systemic inflammation.
    European Journal of Pediatrics 05/2004; 163(4-5):229-33. · 1.91 Impact Factor