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61.
《Burns : journal of the International Society for Burn Injuries》2021,47(6):1451-1455
BackgroundBurn injury continues to cause significant morbidity and mortality in the US pediatric population. Many studies using inpatient samples have found a relationship between low socioeconomic status (SES) and burn injury. The purpose of our study was to evaluate the association between SES and the likelihood of admission for Emergency Department (ED) visits for pediatric burn injury.Study designA retrospective database review of pediatric ED visits for burn injury from a statewide hospital system, from January 1, 2005 to December 31, 2014. SES was assigned using an eight factor Neighborhood Risk Index (NRI) created from census block group data, with a higher score indicative of lower SES. The outcome measure was ED visits admitted to inpatient care.ResultsWe analyzed a sample of 1845 pediatric ED visits for burn injuries. Most visits were discharged from the ED (88.4%) while 10.5% were admitted to inpatient care and 1.0% were transferred to another hospital. In a multivariable logistic regression model, patients from high risk areas (>75th percentile NRI) had 1.58 higher odds of inpatient admission compared to patients from low risk areas (<75th percentile NRI; 95% CI: 1.08–2.30), after adjusting for age, gender, ethnicity, distance to the hospital, and previous ED visit for burn injury in the past 30 days. In addition, for every 1-mile increase in distance, a child’s likelihood of admission increased by 6% (95% CI: 4–9%).ConclusionsChildren with a burn injury from the highest risk socioeconomic areas in Rhode Island had a higher likelihood of inpatient admission. Further research is needed to determine what factors associated with socioeconomic status impact this finding. 相似文献
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63.
Glen Zi Qiang Liau Hong Yi Lin Yuhang Wang Kameswara Rishi Yeshayahu Nistala Chin Kai Cheong James Hoi Po Hui 《Indian Journal of Orthopaedics》2021,55(1):55
PurposeFractures of the femoral shaft in children are common. The rates of bone growth and remodeling in children vary according to their ages, which affect their respective management. MethodsThis paper evaluates the incidence and patterns of pediatric femoral shaft fracture and the current concepts of treatments available.ResultsThe type of fracture—closed or open; stable or unstable—needs to be taken into account. Child abuse should be suspected in fractures sustained by infants. For younger children, non-surgical management is preferred, which include Pavlik harness (< 6 months old) and early spica casting (6 months to 6 years old). Older children (> 6 years old) usually benefit from surgical treatments as outcomes of non-surgical alternatives are worse and are associated with prolonged recovery times. These operative measures for older children that are 6–12 years old include elastic stable intramedullary nailing and submuscular plating. Factors to be considered when devising an appropriate intervention include body mass, location of injury, and nature of fracture. For adolescent and skeletally mature teenagers (> 12 years old), rigid antegrade entry intramedullary fixation is indicated. In the event of open fractures or polytrauma, external fixation should be considered as a temporary treatment method for initial fracture stabilization.ConclusionAn age-based and evidence-based algorithm has been proposed to guide surgeons in the process of evaluating an appropriate treatment. 相似文献
64.
《Neuro-Chirurgie》2021,67(4):383-390
Osteoblastoma of the skull is a rare entity, and they account only for 2-4% of all the cases of osteoblastoma. We perform a comprehensive review of the pertinent literature on the subject and we report a case of a 3-year-old girl presenting with a 6-month history of a supraorbital mass and exophthalmos due to an osteoblastoma of the frontal and ethmoid bones involving the orbit and anterior skull base. A 3D printed model of the patient's skull was used for the preoperative planning and reconstruction strategy. Total en-bloc resection of the tumor followed by immediate reconstruction was achieved. No recurrence was detected 3 years after the surgery. Gross total resection is strongly advised with skull osteoblastoma, especially in young age, because of the risk of the recurrence and malignant transformation. 3D printing is proven to be a valuable tool to enhance surgical performance by avoiding complications while achieving total resection with accurate reconstruction. Long-term follow-up is important to detect recurrences and improve the management of these young patients. 相似文献
65.
目的探讨吲哚菁绿荧光引导腹腔镜解剖性肝段获取术在小儿活体肝移植中的应用价值。方法采用回顾性描述性研究方法。收集2019年12月至2020年1月首都医科大学附属北京友谊医院收治的2例行活体肝移植患儿和2例供者的临床资料。病例1,女,年龄为1岁,体质量为8.7 kg。供者为患儿父亲,年龄为35岁,体质量为93.1 kg。病例2,男,年龄为1岁,体质量为7.5 kg。供者为患儿父亲,年龄为39岁,体质量为84.0 kg。2例供者均行吲哚菁绿荧光引导腹腔镜解剖性肝段获取术获取供肝。观察指标:(1)供者手术情况。(2)供者术后情况。(3)受者术后情况。(4)随访情况。采用电话、门诊、短信、微信方式进行随访。供者于术后第1、3、6个月随访1次,了解肝功能恢复情况。受者于术后每周随访1次,了解移植物功能情况,以及排斥反应、胆汁漏、胆道狭窄、血栓形成、血管狭窄等并发症发生情况。随访时间截至2020年7月。结果(1)供者手术情况。病例1供者总手术时间为234 min,供肝减体积处理时间为40 min,术中出血量为60 mL,未输血。经减体积处理后供肝实际质量为225.2 g。病例2供者总手术时间为220 min,供肝减体积处理时间为40 min,术中出血量为40 mL,未输血。经减体积处理后供肝实际质量为178.0 g。(2)供者术后情况。病例1供者丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)于术后第2天达到峰值,分别为493 U/L、186.0 U/L、30.66μmol/L,于术后第3天下降为388 U/L、90.9 U/L、22.57μmol/L;术后首次下床活动时间为术后2 d、术后首次进食流质食物时间为术后1 d、术后拔除腹腔引流管时间为术后3 d、术后住院时间为4 d、围术期无≥Clavien-DindoⅡ级并发症发生。病例2供者ALT、AST、TBil于术后第1天达到峰值,分别为602 U/L、454.6 U/L、30.49μmol/L,于术后第4天下降为355 U/L、55.7 U/L、20.65μmol/L;术后首次下床活动时间为术后2 d、术后首次进食流质食物时间为术后1 d、术后拔除腹腔引流管时间为术后3 d、术后住院时间为5 d、围术期无≥Clavien-DindoⅡ级并发症发生。(3)受者术后情况。病例1 ALT、AST、TBil于术后第1天达到峰值,分别为670 U/L、288.7 U/L、22.13μmol/L,于术后第14天下降为54 U/L、33.0 U/L、5.75μmol/L;术后住院时间为20 d,围术期无≥Clavien-DindoⅡ级并发症发生。病例2 ALT、AST、TBil于术后第1天达到峰值,分别为520 U/L、93.9 U/L、31.42μmol/L,于术后第14天下降为87 U/L、60.8 U/L、11.51μmol/L;术后住院时间为25 d,围术期无≥Clavien-DindoⅡ级并发症发生。(4)随访情况。2例供者均获得术后1、3、6个月随访,术后1个月随访肝功能恢复至正常水平,术后3个月及6个月随访肝功能未见异常。2例受者均获得术后每周随访。随访期间,移植物功能均正常,均未发生排斥反应、胆汁漏、胆道狭窄、血栓形成、血管狭窄等并发症。结论吲哚菁绿荧光引导腹腔镜解剖性肝段获取术应用于小儿活体肝移植安全、可行,可由具有丰富腹腔镜供肝获取手术经验的团队施行。 相似文献
66.
67.
John A. Ozolek 《Head and neck pathology》2021,15(1):85
The goals of this chapter in keeping with the overall general themes of this special edition will be (1) to highlight aspects of development of the thyroid and parathyroid glands with particular focus on the role and contribution of the neural crest (or not) and how this may impact on the pathology that is seen, (2) to emphasize those lesions particularly more commonly arising in the pediatric population that actually generate specimens that the surgical pathologist would encounter, and (3) highlight more in depth specific lesions associated with heritable syndromes or specific gene mutations since the heritable syndromes tends to manifest in the pediatric age group. In this light, the other interesting areas of pediatric thyroid disease including medical thyroid diseases, congenital hypothyroidism, anatomic variants and aberrations of development that lead to structural anomalies will not be emphasized here. 相似文献
68.
69.
目的:探讨应用针形内窥镜对小儿鼻颅底疾病进行探查与手术的方法及疗效。方法:在外径1.9mm的进口针形内窥镜及电视同图像系统监视下,对8例小儿(7d ̄12岁)鼻颅底有关疾病进行探杳与手术。结果:先天性后鼻孔闭锁3例中,1例好转,3例痊愈。外伤性脑脊液鼻漏1例,经修补痊愈先天性脑膜脑膨出2例,确诊后1例暂缓治疗。另1例行内窥镜手术痊愈。颅底神经母细胞瘤2例取材作病理检查确诊。结论:在电视图像监视下应用 相似文献
70.
《Journal of microbiology, immunology, and infection》2023,56(2):299-310
BackgroundSince 2015, 13-valent pneumococcal conjugate vaccine (PCV13) was included in the national immunization program in Taiwan. Subsequently, the serotypes of the main circulating Streptococcus pneumoniae strains have changed. PCV administration is also associated with changes in the antimicrobial susceptibility of S. pneumoniae strains. Therefore, in this study, we analyzed the serotype distribution and antimicrobial susceptibility of S. pneumoniae in pediatric infections.MethodsChildren with S. pneumoniae infections, including invasive pneumococcal disease (IPD) and non-IPD, were enrolled from January 2010 to December 2020. The samples were collected from Mackay Memorial Hospital, MacKay Children's Hospital, and Hsinchu Mackay Hospital in Taiwan. We analyzed the epidemiology of sample collection site, infection diagnosis, and the serotype and antimicrobial susceptibility of S. pneumoniae strains. The study period was divided into time points before and after PCV13 administration.ResultsIn total, 322 isolates were collected during the study period. The incidence of IPD declined annually, from 29.7% before 2015 to 7.3% after 2015 (p < 0.001). The prevalence of serotype 19 A had increased gradually since 2010 but declined rapidly after 2013. Serotypes 15 A and 23 A were the most common serotypes after 2015. The non-susceptibility of the S. pneumoniae isolates to penicillin, cefotaxime, and ceftriaxone decreased. Based on meningitis breakpoints, the non-susceptibility to cefotaxime and ceftriaxone gradually decreased, but increased in 2020.ConclusionPCV13 was considerably effective in reducing the incidence of IPD in children; however, the prevalence of serotypes 15 A and 23 A increased. The increase in antimicrobial non-susceptibility caused by non-vaccine serotypes must be continuously monitored. 相似文献