共查询到20条相似文献,搜索用时 31 毫秒
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Rohit Saxena Rajesh Sinha Amitabh Purohit Tanuj Dada Rasik B. Vajpayee Raj V. Azad 《Indian journal of pediatrics》2002,69(11):863-867
Objective : The aim of the study is to identify the causes, demographic and clinical profile and evaluate final visual outcome of pediatric
ocular injuries.Methods : Two hundred and four children aged fourteen years or less presenting to the emergency services of a tertiary care centre
with ocular injury were included. Demographic data, nature and cause of injury, duration between injury and presentation to
an ophthalmologist and the diagnosis were recorded. Evaluation of visual acuity, anterior segment and fundus were done. All
patients were appropriately managed and followed up on days 1, 7,1 month, 3 and 6 months.Result : Majority of injuries occurred in children of 5 years and older (87.7%). There were 133 (65.1%) boys and 71 (34.9%) girls.
Forty-nine (24%) cases presented within 6 hours of injury while 70 (34.3%) presented after more than 24 hours after trauma.
Most common cause of injury was bow and arrow (15.2%) followed by household appliances (14.3%). Closed globe injuries accounted
for 42.2% injuries, open globe for 53.9% and 3.9% were chemical injuries. Best corrected visual acuity of 6/12 or better was
achieved in 79 eyes (91.86%) in closed globe group. However, only 17 eyes (15.45%) in open globe group could achieve this.Conclusion : Most ocular injuries in children are preventable and occur from unsupervised games like bow and arrow and firecracker,
which can lead to significant visual loss. 相似文献
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Pattern of pediatric ocular trauma in India 总被引:2,自引:0,他引:2
Saxena R Sinha R Purohit A Dada T Vajpayee RB Azad RV 《Indian journal of pediatrics》2002,69(10):863-867
OBJECTIVE: The aim of the study is to identify the causes, demographic and clinical profile and evaluate final visual outcome of pediatric ocular injuries. METHODS: Two hundred and four children aged fourteen years or less presenting to the emergency services of a tertiary care centre with ocular injury were included. Demographic data, nature and cause of injury, duration between injury and presentation to an ophthalmologist and the diagnosis were recorded. Evaluation of visual acuity, anterior segment and fundus were done. All patients were appropriately managed and followed up on days 1, 7, 1 month, 3 and 6 months. RESULT: Majority of injuries occurred in children of 5 years and older (87.7%). There were 133 (65.1%) boys and 71 (34.9%) girls. Forty-nine (24%) cases presented within 6 hours of injury while 70 (34.3%) presented after more than 24 hours after trauma. Most common cause of injury was bow and arrow (15.2%) followed by household appliances(14.3%). Closed globe injuries accounted for 42.2% injuries, open globe for 53.9% and 3.9% were chemical injuries. Best corrected visual acuity of 6/12 or better was achieved in 79 eyes (91.86%) in closed globe group. However, only 17 eyes (15.45%) in open globe group could achieve this. CONCLUSION: Most ocular injuries in children are preventable and occur from unsupervised games like bow and arrow and firecracker, which can lead to significant visual loss. 相似文献
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Jason D. Fraser Pablo Aguayo Daniel J. Ostlie Shawn D. St. Peter 《Pediatric surgery international》2009,25(2):125-132
Due to the size and location within the pediatric patient, the kidneys are susceptible to injury from blunt trauma. While
it is clear that the goal of management of blunt renal trauma in children is renal preservation, the methods of achieving
this goal have not been well established in the current literature. Therefore, we have set out to summarize and clarify the
current published information on the management strategies for blunt renal trauma in children. While there is extensive literature
available, it consists mostly of retrospective series documenting widely varied management styles. The purpose of this review
is to display the current information available and delineate the role for future studies that may allow us to develop consistent
management strategies of pediatric patients, who have sustained blunt renal trauma, in a safe and cost-effective manner. 相似文献
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《Seminars in Pediatric Surgery》2017,26(1):36-42
Pediatric thoracic trauma is relatively uncommon but results in disproportionately high levels of morbidity and mortality when compared with other traumatic injuries. These injuries are often more devastating due to differences in children׳s anatomy and physiology relative to adult patients. A high index of suspicion is of utmost importance at the time of presentation because many significant thoracic injuries will have no external signs of injury. With proper recognition and management of these injuries, there is an associated improved long-term outcome. This article reviews the current literature and discusses the initial evaluation, current management practices, and future directions in pediatric thoracic trauma. 相似文献
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Nabaweesi R Arnold MA Chang DC Rossberg MI Ziegfeld S Sawaya DE Bathurst MA Colombani P Abdullah F 《Pediatric surgery international》2008,24(9):1053-1056
Pelvic fractures are uncommon in children, but can occur as a result of high-energy impact injuries to the lower torso in association with blunt trauma. Pelvic fractures can be associated with significant morbidity while the work-up and treatment for these injuries is costly. The aim was to identify risk factors that help determine which pediatric trauma patients are at highest risk of sustaining a pelvic fracture to aid in the development of criteria for the targeted use of pelvic radiographic imaging. A retrospective analysis was conducted using the only pediatric trauma registry in the state of Maryland, located at The Johns Hopkins Children's Center. All blunt trauma patients who were younger than 15 years of age from 1990 to 2005 were included in the analysis (n = 13,360) with a final diagnosis of pelvic fracture as the primary outcome of interest. Comparisons were made using Pearson's chi-square for categorical and the Mann-Whitney rank sum test for non-normally distributed variables. Pelvic fractures following blunt trauma in children are associated with age, race, place and mechanism of injury. Compared to children 4 years and younger, pelvic fractures were more likely to occur in children aged 5-9 years (OR = 3; P = 0.000), as well as 10-14 years (OR = 5; P = 0.000). Compared to blunt trauma injuries from falls, children who were struck by vehicles or who were occupants in motor vehicle crashes (MVC) were six times (P = 0.000) and twice (P = 0.02) as likely to sustain a pelvic fracture, respectively. Four factors were demonstrated by this study to be significantly associated with pediatric pelvic fractures: being Caucasian, age between 5 and 14 years, being struck as a pedestrian or a motor vehicle crash occupant. Identification of these factors may aid clinicians in selecting patients who are at highest risk for pelvic fracture and may benefit most from pelvic radiography. 相似文献
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The Pediatric Trauma Score (PTS) is rapidly gaining acceptance for use in prehospital triage. This study examines its reliability
in predicting mortality. The charts of the 533 trauma patients hospitalized between 1984–1989 were reviewed and the PTS was
calculated for each. There were 3 deaths in 370 patients with PTS >8, while 24 of 163 children with PTS ⩽8 died. Size categorization
was found to be overemphasized because of the low mortality (7.7%) in children smaller than 10 kg, although their mean PTS
(6.4 ± 2.1) was significantly lower than the mean PTS (9.0 ± 2.2) of children over 10 kg. Forty-nine of 71 surgically treated
patients having intra-abdominal organ injuries had a PTS >8. The existing parameters of PTS did not have equal relationships
to mortality, and may even all be inadequate in the correct triage of children with blunt abdominal trauma.
Correspondence to: E. Balık 相似文献
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Karen N. Lynn Gabriel M. Werder Rachel M. Callaghan Ashley N. Sullivan Zafar H. Jafri David A. Bloom 《Pediatric radiology》2009,39(9):904-916
Abdominal trauma is a leading cause of death in children older than 1 year of age. The spleen is the most common organ injured
following blunt abdominal trauma. Pediatric trauma patients present unique clinical challenges as compared to adults, including
different mechanisms of injury, physiologic responses, and indications for operative versus nonoperative management. Splenic
salvage techniques and nonoperative approaches are preferred to splenectomy in order to decrease perioperative risks, transfusion
needs, duration/cost of hospitalization, and risk of overwhelming postsplenectomy infection. Early and accurate detection
of splenic injury is critical in both adults and children; however, while imaging findings guide management in adults, hemodynamic
stability is the primary determinant in pediatric patients. After initial diagnosis, the primary role of imaging in pediatric
patients is to determine the level and duration of care. We present a comprehensive literature review regarding the mechanism
of injury, imaging, management, and complications of traumatic splenic injury in pediatric patients. Multiple patients are
presented with an emphasis on the American Association for the Surgery of Trauma organ injury grading system. Clinical practice
guidelines from the American Pediatric Surgical Association are discussed and compared with our experience at a large community
hospital, with recommendations for future practice guidelines. 相似文献
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There are few reports of adrenal injuries complicating inflicted pediatric trauma. All child-abuse cases at the New York
City Medical Examiner's Office over a 7-year period were reviewed. Of these 121 homicides, 50 sustained severe injuries to
the torso. Five infants (10.0%) had adrenal laceration, a marker of major blunt-force injury.
Accepted: 21 January 1999 相似文献
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《Seminars in Pediatric Surgery》2017,26(1):43-46
Over 700,000 children are victims of abuse and neglect each year in the United States. Effective screening programs that entail broad capture of suspected non-accidental trauma (NAT) may help to identify sentinel injuries. This can facilitate earlier detection and psychosocial interventions in hopes of decreasing recurrent NAT, which confers a higher mortality rate. The purpose of this article is to outline essential components of hospital-based NAT screening tools and highlight existing programs. In general, these tools should include several components: education sessions for healthcare providers on how to identify signs of NAT, automated notes or checklists within the electronic medical record to prompt specialty referrals, and a multidisciplinary team of experts that can address the needs of these children in the acute care setting. 相似文献
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Julie L Lerwick 《World Journal of Clinical Pediatrics》2016,5(2):143-150
Frequently, episodes of care such as preventive clinic visits, acute care, medical procedures, and hospitalization can be emotionally threatening and psychologically traumatizing for pediatric patients. Children are often subject to psychological trauma, demonstrated by anxiety, aggression, anger, and similar expressions of emotion, because they lack control of their environment. This sense of helplessness, coupled with fear and pain can cause children to feel powerless in healthcare settings. These emotional responses can delay important medical treatment, take more time to complete and can reduce patient satisfaction. Healthcare professionals are uniquely positioned to prevent healthcare-induced trauma and reduce healthcare-induced anxiety. This article introduces a new way to choice, agenda, resilience and emotion (CARE) for pediatric patients in the healthcare setting by implementing the four following treatment principles called the care process: (1) Choices: Offer power in a powerless environment; (2) Agenda: Let patients and families know what to expect and what is expected of them; (3) Resilience: Highlight strengths and reframe negatives; and (4) Emotional support: Recognize and normalize common fears and responses. Engaging the CARE principles helps patients and families feel empowered and mitigates, reduces, and may even ameliorate risk of anxiety and trauma responses. 相似文献
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《Journal of pediatric urology》2020,16(5):559.e1-559.e6
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Holland AJ 《Journal of paediatrics and child health》2005,41(12):623-624
Abstract: Trauma remains the most common cause of death in childhood after the first year of life. It accounts for considerable morbidity that may extend into adult life at great cost to the community. Despite the scale of the disease, paediatric trauma and injury prevention research attract little funding. International data indicate that children in Australia and New Zealand would benefit from improved injury prevention strategies and the introduction of a more formalized paediatric trauma system. Such a system would need to take account of Australasian geographical and population distribution characteristics, which mandate local provision of expert and immediate care in rural areas. There would appear to be economic and clinical arguments for the introduction of an ambulance trauma bypass system for stable but severely injured children in metropolitan areas with a paediatric trauma centre. 相似文献
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Zachary A. Glaser Nikhi Singh Connor Koch Pankaj P. Dangle 《Journal of pediatric urology》2021,17(2):236.e1-236.e8
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Background To report a case of fatal tension pneumocephalus in a 9-year-old boy following a severe motor vehicle accident.
Methods A young boy with a serious closed head injury was resuscitated in the emergency room and underwent CT scan of the head and
orbits.
Results The CT-scan revealed a fracture of the orbital roof with extensive bilateral pneumocephalus.
Conclusions A high index of suspicion for tension pneumocephalus is required in patients with severe head injuries presenting with periorbital
swelling and perioccular trauma. A prompt CT scan and neurosurgical intervention are indicated. 相似文献
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Urethral trauma in children 总被引:7,自引:0,他引:7
We report our 12-year experience in the management of urethral injuries in nine children, six boys and three girls. The most
common mechanisms of injury were motor vehicle accidents, followed by straddle injuries. All the injuries in boys involved
the anterior urethra, and in girls the proximal or mid-urethra. There were associated injuries in five, including three pelvic
fractures. All children were investigated with a retrograde urethrogram. Four were treated non-operatively with insertion
of a urethral catheter. Of the remaining five, one had drainage of a penile haematoma, one cystourethroscopy, two insertion
of urinary and suprapubic catheters, and one open cystotomy and passage of a guide wire with antegrade passage of a urethral
catheter. Complications included one urinary tract infection, one urethral fistula, one urethrovaginal fistula, and two urethral
strictures. Final outcome was satisfactory in all nine children.
Accepted: 3 February 2000 相似文献
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