scholarly journals Paediatric injuries due to falls from windows and balconies: an 8-year prospective and retrospective review

2020 ◽  
Author(s):  
Manasi Rajagopal ◽  
Manu Kundra ◽  
Neelam Mabood ◽  
Samina Ali ◽  
Tara Rankin ◽  
...  
Keyword(s):  
Interquartile Range ◽  
Prospective Data ◽  
Admission Rates ◽  
Major Injury ◽  
Height Of Fall ◽  
Minor Injuries ◽  
Safety Features ◽  
Unintentional Falls ◽  
Record Review ◽  
Retrospective Medical Record Review

Abstract Background Unintentional falls from windows and balconies pose a serious health risk to children. Limited Canadian data describing such falls currently exist. This study aimed to describe the frequency, demographic characteristics, injury patterns, and risk factors associated with paediatric falls from windows and balconies. Methods This study employed both prospective data collection and retrospective medical record review. Prospectively, consenting families were enrolled from February 2015 to February 2017; retrospectively, charts from January 2009 to December 2014 were reviewed. Children 0 to 16 years of age, who presented to the Stollery Children’s Hospital (Edmonton, Alberta) emergency department due to a fall from a window or balcony, were included. Results A total of 102 children were included; thirty were enrolled prospectively and 72 retrospectively. Median age was 4.5 years (interquartile range 2.83 to 6.83) with 63.7% (65 of 102) males. About 87.2% (89 of 102) of falls were from windows and 12.8% (13 of 102) from balconies. The median estimated height of fall was 4.1 m (interquartile range 3.04 to 4.73). About 58.4% (59 of 101) had at least one major injury (i.e., concussion, fractured skull, internal injury, fractured limb, severe laceration), 36.6% had minor injuries only (i.e., abrasions, contusions, sprains), and 5.0% had no documented injuries. There were no fatalities. About 30.4% (31 of 102) were admitted, with 48.4% of these children (15 of 31) requiring surgery. Conclusion Most falls from windows and balconies occurred in children under the age of 5 years and were associated with serious morbidity, high admission rates, and need for surgery. Child supervision as well as installation of key safety features in windows may help minimize paediatric fall-related injuries.

scholarly journals Impact of pre-dialysis nephrology care engagement and decision-making on provider and patient action toward permanent vascular access

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Vanessa Grubbs ◽  
Bernard G. Jaar ◽  
Kerri L. Cavanaugh ◽  
Patti L. Ephraim ◽  
Jessica M. Ameling ◽  
...  
Keyword(s):  
Decision Making ◽  
Public Hospital ◽  
Veterans Administration ◽  
Engagement In Care ◽  
Vascular Surgeon ◽  
Patient Level ◽  
Nephrology Care ◽  
Record Review ◽  
Retrospective Medical Record Review

Abstract Background While catheters are often thought the result of emergency hemodialysis (HD) initiation among patients with little or no pre-dialysis nephrology care, the role of patient level of engagement in care and modality decision-making have not been fully explored. Methods This is a retrospective medical record review of adults (age 18–89 years) who received care in academically affiliated private practice, public hospital, or Veterans Administration settings prior to initiating HD with a catheter between 10/1/2011 and 9/30/2012. Primary predictors were level of patient engagement in nephrology care within 6 months of HD initiation and timing of modality decision-making. Primary outcomes were provider action (referral) and any patient action (evaluation by a vascular surgeon, vein mapping or vascular surgery) toward [arteriovenous fistula or graft, (AVF/AVG)] creation. Results Among 92 incident HD patients, 66% (n = 61) initiated HD via catheter, of whom 34% (n = 21) had ideal engagement in care but 42% (n = 25) had no documented decision. Providers referred 48% (n = 29) of patients for AVF/AVG, of whom 72% (n = 21) took any action. Ideal engagement in care predicted provider action (adjusted OR 13.7 [95% CI 1.08, 175.1], p = 0.04), but no level of engagement in care predicted patient action (p > 0.3). Compared to patients with no documented decision, those with documented decisions within 3, 3–12, or more than 12 months before initiating dialysis were more likely to have provider action toward AVF/AVG (adjusted OR [95% CI]: 9.0 [1.4,55.6], p = 0.2, 37.6 [3.3423.4] p = 0.003, and 4.8 [0.8, 30.6], p = 0.1, respectively); and patient action (adjusted OR [95% CI]: 18.7 [2.3, 149.0], p = 0.006, 20.4 [2.6, 160.0], p = 0.004, and 6.2 [0.9, 44.0], p = 0.07, respectively). Conclusions Timing of patient modality decision-making, but not level of engagement in pre-dialysis nephrology care, was predictive of patient and provider action toward AVF/AVG Interventions addressing patients’ psychological preparation for dialysis are needed.

scholarly journals Symptom burden and splenomegaly in patients with myelofibrosis in the U nited S tates: a retrospective medical record review

2013 ◽  
Vol 2 (6) ◽  
pp. 889-898 ◽  
Author(s):  
Debanjali Mitra ◽  
James A. Kaye ◽  
Lance T. Piecoro ◽  
Jennifer Brown ◽  
Kelly Reith ◽  
...  
Keyword(s):  
Medical Record ◽  
Symptom Burden ◽  
Medical Record Review ◽  
Record Review ◽  
Retrospective Medical Record Review

Malaria in Children in Chicago

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 83-85
Author(s):  
Benjamin Emanuel ◽  
Neil Aronson ◽  
Stanford Shulman
Keyword(s):  
United States ◽  
Pediatric Population ◽  
The United States ◽  
Malaria Endemic Area ◽  
Overseas Travel ◽  
History Of ◽  
Record Review ◽  
Recent Immigration ◽  
Childhood Malaria ◽  
Retrospective Medical Record Review

Objective. To review the experience of a large children's hospital and two community hospitals in Chicago in which malaria was diagnosed in children during a recent 6-year period. Methods. Retrospective medical record review covering the years 1985 to 1990. Results. Twenty cases of childhood malaria were diagnosed, generally in patients hospitalized for fever unresponsive to oral antibiotics also associated with splenomegaly, with presumptive diagnoses of malignancy, typhoid fever, acute appendicitis, or urinary tract infection. History of recent immigration to the United States or travel to a malaria-endemic area was frequently not elicited until several days into hospitalization, thus delaying diagnosis and therapy. Conclusions. Because malaria in the United States pediatric population has increased as a result of foreign immigration and overseas travel, pediatricians must be alert to the possibility of malaria in febrile children, and the importance of antimalarial prophylaxis should be communicated to parents of children traveling to endemic areas.

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