Influenza in children is a significant cause of morbidity and mortality. Presenting symptoms of influenza vary greatly among children; clinical presentation should be assessed for severity of illness and potential complications. Available clinical and laboratory findings should be used to guide treatment for young children with fever. Clinicians should be aware of up-to-date recommendations to diagnose and treat children with influenza and to ensure public health engagement to prevent and manage influenza epidemics. This issue reviews common complications of influenza infection, offers guidance for infection control measures, and provides evidence-based recommendations for the management of pediatric patients with influenza in the emergency department.
{"title":"Pediatric influenza in the emergency department: diagnosis and management.","authors":"Ran D Goldman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Influenza in children is a significant cause of morbidity and mortality. Presenting symptoms of influenza vary greatly among children; clinical presentation should be assessed for severity of illness and potential complications. Available clinical and laboratory findings should be used to guide treatment for young children with fever. Clinicians should be aware of up-to-date recommendations to diagnose and treat children with influenza and to ensure public health engagement to prevent and manage influenza epidemics. This issue reviews common complications of influenza infection, offers guidance for infection control measures, and provides evidence-based recommendations for the management of pediatric patients with influenza in the emergency department.</p>","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"18 1","pages":"1-20"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38374298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-30DOI: 10.22470/pemj.2020.00094
Sung-Yun Ma, D. Kim, Juyoung Lee, K. Cho, J. Suh, Soo-Young Lee
폐렴마이코플라즈마(Mycoplasma pneumoniae)는 지역 사회 폐렴의 주요 원인균이다. 이 세균에 의한 폐렴은 학령 기 소아 및 젊은 성인에 호발하고, 4-7년마다 유행한다. 마이코플라즈마 폐렴에 대한 1차 선택약으로 macrolide 계 항균제를 사용하는데, macrolide-refractory M. pneumoniae (MRMP) 폐렴이 증가하는 추세이다. MRMP 폐 렴은 임상증상이 심하고 예후가 나빠서, 병인 규명 및 치 료법 개발을 위한 연구가 진행 중이다. 최근 한국 지침은 세균의 내성 기전을 극복하는 2차 항균제 및 숙주의 과도 한 면역반응을 제어하는 항염증제 요법을 권고한다. 마이코플라즈마 감염 자체의 경과는 양호하지만, 조절 되지 않는 면역반응으로 피부, 중추신경계, 혈액, 심장, 위 장관, 근골격계를 침범하는 폐 외 합병증이 유발될 수 있 다. 드물지만 심각한 혈액학적 합병증으로, 적혈구포식림 프조직구증(hemophagocytic lymphohistiocytosis, HLH) 이 발생할 수 있다. 본 저자는 MRMP 폐렴에 대한 항 균제 및 항염증제 병합요법에도 지속적인 열, 간비장비대, 혈소판감소증을 보인 6세 환자에서 HLH를 의심하고 치 료한 증례를 문헌고찰과 함께 보고한다. 본 연구는 가톨릭 Macrolide 불응성 마이코플라즈마 폐렴과 적혈구포식림프조직구증: 증례보고와 문헌고찰
肺炎支原体(Mycoplasma pneumoniae)是社区肺炎的主要致病菌。该细菌引起的肺炎在学龄期儿童及年轻成人发病，每4 ~ 7年流行一次。作为支原体肺炎的首选药物，使用macrolide类抗菌剂，macrolide-refractory M. pneumoniae (MRMP)肺炎呈增加趋势。由于MRMP肺炎临床症状严重、预后不良，目前正在进行查明病因及开发治疗方法的研究。最近，韩国的方针建议采用克服细菌耐性的2次抗菌剂及抑制宿主过度免疫反应的抗炎症剂疗法。支原体感染本身经过良好，但由于没有调节的免疫反应，可能会引发侵犯皮肤、中枢神经系统、血液、心脏、胃部长、筋骨系统的肺外并发症。罕见而严重的血液学并发症可导致红细胞吞噬lymphohistiocytosis (HLH)。本作者将对MRMP肺炎的抗菌剂及抗炎症剂合并疗法持续发热、肝脾肥大、血小板减少等6岁患者怀疑HLH并治疗的病例进行文献考察并进行报告。本研究研究天主教Macrolide不应性支原性肺炎和红细胞吞噬淋巴组织细胞症:病例报告和文献考察
{"title":"Macrolide-refractory Mycoplasma pneumoniae pneumonia and hemophagocytic lymphohistiocytosis: case report and literature review","authors":"Sung-Yun Ma, D. Kim, Juyoung Lee, K. Cho, J. Suh, Soo-Young Lee","doi":"10.22470/pemj.2020.00094","DOIUrl":"https://doi.org/10.22470/pemj.2020.00094","url":null,"abstract":"폐렴마이코플라즈마(Mycoplasma pneumoniae)는 지역 사회 폐렴의 주요 원인균이다. 이 세균에 의한 폐렴은 학령 기 소아 및 젊은 성인에 호발하고, 4-7년마다 유행한다. 마이코플라즈마 폐렴에 대한 1차 선택약으로 macrolide 계 항균제를 사용하는데, macrolide-refractory M. pneumoniae (MRMP) 폐렴이 증가하는 추세이다. MRMP 폐 렴은 임상증상이 심하고 예후가 나빠서, 병인 규명 및 치 료법 개발을 위한 연구가 진행 중이다. 최근 한국 지침은 세균의 내성 기전을 극복하는 2차 항균제 및 숙주의 과도 한 면역반응을 제어하는 항염증제 요법을 권고한다. 마이코플라즈마 감염 자체의 경과는 양호하지만, 조절 되지 않는 면역반응으로 피부, 중추신경계, 혈액, 심장, 위 장관, 근골격계를 침범하는 폐 외 합병증이 유발될 수 있 다. 드물지만 심각한 혈액학적 합병증으로, 적혈구포식림 프조직구증(hemophagocytic lymphohistiocytosis, HLH) 이 발생할 수 있다. 본 저자는 MRMP 폐렴에 대한 항 균제 및 항염증제 병합요법에도 지속적인 열, 간비장비대, 혈소판감소증을 보인 6세 환자에서 HLH를 의심하고 치 료한 증례를 문헌고찰과 함께 보고한다. 본 연구는 가톨릭 Macrolide 불응성 마이코플라즈마 폐렴과 적혈구포식림프조직구증: 증례보고와 문헌고찰","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"20 1","pages":"145-150"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81966144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-30DOI: 10.22470/pemj.2020.00066
Myoung Hoon Lee, J. Jang, J. Cho, W. Choi, J. Choi
Purpose: Methods for suicide attempt are largely divided into poisoning and non-poisoning, which differ in clinical features and severity. We aimed to investigate the clinical features of adolescents with suicide attempt and factors associated with poor outcomes from the 2 methods. Methods: A retrospective study was conducted on adolescents (10-18 years) who visited the emergency department after suicide attempt from 2011 through 2018. The adolescents were divided into the poisoning and non-poisoning groups. We analyzed the differences of clinical features and outcomes between the 2 groups. Poor outcomes were defined as hospitalization to the intensive care unit or death. Factors associated with poor outcomes were investigated using multivariable logistic regression. Results: Of 4,335 adolescents in total, 2,134 (49.2%) were categorized as the poisoning group. In this group, the adolescents with poor outcomes used acetaminophen most frequently (26.5%), followed by sedative or antipsychotics (22.3%). In the nonpoisoning group, those with the outcomes used fall from height (73.2%) most commonly, followed by hanging (21.0%). The factors associated with the outcomes were age (for increment of 1 year; odds ratio, 1.11; 95% confidence interval, 1.02-1.22) in the poisoning group, and being boys (1.34; 1.03-1.73) and non-use of alcohols (2.87; 1.73-4.74) in the non-poisoning group. Conclusion: In adolescents who used poisoning for suicide attempt, increasing age is associated with poor outcomes. The outcomes are associated with being boys and non-use of alcohols in those who used non-poisoning methods.
{"title":"Clinical features of adolescents with suicide attempt and the factors associated with their outcomes: poisoning versus non-poisoning","authors":"Myoung Hoon Lee, J. Jang, J. Cho, W. Choi, J. Choi","doi":"10.22470/pemj.2020.00066","DOIUrl":"https://doi.org/10.22470/pemj.2020.00066","url":null,"abstract":"Purpose: Methods for suicide attempt are largely divided into poisoning and non-poisoning, which differ in clinical features and severity. We aimed to investigate the clinical features of adolescents with suicide attempt and factors associated with poor outcomes from the 2 methods. Methods: A retrospective study was conducted on adolescents (10-18 years) who visited the emergency department after suicide attempt from 2011 through 2018. The adolescents were divided into the poisoning and non-poisoning groups. We analyzed the differences of clinical features and outcomes between the 2 groups. Poor outcomes were defined as hospitalization to the intensive care unit or death. Factors associated with poor outcomes were investigated using multivariable logistic regression. Results: Of 4,335 adolescents in total, 2,134 (49.2%) were categorized as the poisoning group. In this group, the adolescents with poor outcomes used acetaminophen most frequently (26.5%), followed by sedative or antipsychotics (22.3%). In the nonpoisoning group, those with the outcomes used fall from height (73.2%) most commonly, followed by hanging (21.0%). The factors associated with the outcomes were age (for increment of 1 year; odds ratio, 1.11; 95% confidence interval, 1.02-1.22) in the poisoning group, and being boys (1.34; 1.03-1.73) and non-use of alcohols (2.87; 1.73-4.74) in the non-poisoning group. Conclusion: In adolescents who used poisoning for suicide attempt, increasing age is associated with poor outcomes. The outcomes are associated with being boys and non-use of alcohols in those who used non-poisoning methods.","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"12 1","pages":"85-93"},"PeriodicalIF":0.0,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85341794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-09DOI: 10.22470/pemj.2020.00157
S. Cho, Ji-hoon Kim, Y. Kyong, K. Cha, Hwan Song, S. Seol
Purpose: We aimed to identify the factors associated with the repeated febrile seizures (RFS), defined as recurrent seizures during the same febrile illness. Methods: We reviewed the medical records of children with febrile seizure who visited 4 academic emergency departments from October 2016 through September 2018. Differences were identified in variables regarding clinical and laboratory characteristics between the children with and without RFS. The RFS was the primary outcome. Logistic regression was conducted to identify factors associated with the occurrence of RFS. Results: Among 1,551 children, 922 were included in the study, of whom, 198 (21.5%) underwent RFS. Of the children with RFS, 188 (94.9%) underwent the recurrences within the initial 24 hours. Logistic regression showed focal seizure (adjusted odds ratio, 6.67; 95% confidence interval, 2.37-18.82), venous pH < 7.31 (5.89; 3.13-11.08), and postictal drowsiness > 30 minutes (1.90; 1.30-2.78) as the factors for RFS. Conclusion: In children with febrile seizure, focal seizure, acidosis, and prolonged postictal state may be independent risk factors for RFS. These findings may be informed to healthcare professionals and parents caring for children with febrile seizure.
{"title":"Risk factors for repeated febrile seizures during the same febrile illness","authors":"S. Cho, Ji-hoon Kim, Y. Kyong, K. Cha, Hwan Song, S. Seol","doi":"10.22470/pemj.2020.00157","DOIUrl":"https://doi.org/10.22470/pemj.2020.00157","url":null,"abstract":"Purpose: We aimed to identify the factors associated with the repeated febrile seizures (RFS), defined as recurrent seizures during the same febrile illness. Methods: We reviewed the medical records of children with febrile seizure who visited 4 academic emergency departments from October 2016 through September 2018. Differences were identified in variables regarding clinical and laboratory characteristics between the children with and without RFS. The RFS was the primary outcome. Logistic regression was conducted to identify factors associated with the occurrence of RFS. Results: Among 1,551 children, 922 were included in the study, of whom, 198 (21.5%) underwent RFS. Of the children with RFS, 188 (94.9%) underwent the recurrences within the initial 24 hours. Logistic regression showed focal seizure (adjusted odds ratio, 6.67; 95% confidence interval, 2.37-18.82), venous pH < 7.31 (5.89; 3.13-11.08), and postictal drowsiness > 30 minutes (1.90; 1.30-2.78) as the factors for RFS. Conclusion: In children with febrile seizure, focal seizure, acidosis, and prolonged postictal state may be independent risk factors for RFS. These findings may be informed to healthcare professionals and parents caring for children with febrile seizure.","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87804743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Points & Pearls: Neonatal resuscitation in the emergency department.","authors":"Kathryn H Pade","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"17 Suppl 12","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38663469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-02DOI: 10.22470/pemj.2020.00171
Y. Shin, Ji‐Man Kang, Jong Gyun Ahn
신생아 루푸스는 임신나이 16-26주에 모체 자가항체가 태반을 통해 전달되어 발생한다. 1954년에 Bridge와 Foley가 모체의 루푸스 관련 인자가 신생아에 전달되는 것을 확인했고, 같은 해 McCuistion과 Schoch가 첫 증 례를 보고했다. 이 질환은 핵단백 항원인 SSA, SSB 또는 U1-리보핵산단백질에 대한 자가항체를 가지는 전신홍반 루푸스, 쇠그렌증후군, 류마티스관절염 등을 진단받은 어 머니로부터 태어난 신생아 중 약 2%에서 발생한다고 알려 졌다. 피부증상(약 40%)이 가장 흔하고 혈구 이상(약 20%), 간기능 이상(약 15-25%)도 나타날 수 있으며, 가 장 치명적인 선천심장차단은 약 25%에서 나타난다. 신생아 루푸스의 임상증상은 선천심장차단 외에는 비특 이적이므로, 열 및 발진으로 응급실을 방문한 3개월 미만 영아에서 이를 감별하기 어렵다. 감염을 우선 감별해야 하 지만, 증상이 지속하면 비교적 드문 감별진단인 신생아 루 푸스를 의심해야 한다. 본 저자는 자가면역질환이 없는 어 머니로부터 태어난 47일 여아가 열 및 발진으로 응급실을 방문하여 패혈증 및 다형홍반을 의심했지만, 상기 질환으 로 최종 진단한 증례를 경험했다. 본 증례는 열 및 발진을 동반한 3개월 미만 영아의 감별진단에 이 질환을 포함해 야 한다는 시사점이 있어, 이를 문헌고찰과 함께 보고한 열과 발진을 주소로 응급실을 방문한 47일 여아에서 진단된 신생아 루푸스
{"title":"A case of neonatal lupus presenting with fever and skin rash in a 47-day-old girl","authors":"Y. Shin, Ji‐Man Kang, Jong Gyun Ahn","doi":"10.22470/pemj.2020.00171","DOIUrl":"https://doi.org/10.22470/pemj.2020.00171","url":null,"abstract":"신생아 루푸스는 임신나이 16-26주에 모체 자가항체가 태반을 통해 전달되어 발생한다. 1954년에 Bridge와 Foley가 모체의 루푸스 관련 인자가 신생아에 전달되는 것을 확인했고, 같은 해 McCuistion과 Schoch가 첫 증 례를 보고했다. 이 질환은 핵단백 항원인 SSA, SSB 또는 U1-리보핵산단백질에 대한 자가항체를 가지는 전신홍반 루푸스, 쇠그렌증후군, 류마티스관절염 등을 진단받은 어 머니로부터 태어난 신생아 중 약 2%에서 발생한다고 알려 졌다. 피부증상(약 40%)이 가장 흔하고 혈구 이상(약 20%), 간기능 이상(약 15-25%)도 나타날 수 있으며, 가 장 치명적인 선천심장차단은 약 25%에서 나타난다. 신생아 루푸스의 임상증상은 선천심장차단 외에는 비특 이적이므로, 열 및 발진으로 응급실을 방문한 3개월 미만 영아에서 이를 감별하기 어렵다. 감염을 우선 감별해야 하 지만, 증상이 지속하면 비교적 드문 감별진단인 신생아 루 푸스를 의심해야 한다. 본 저자는 자가면역질환이 없는 어 머니로부터 태어난 47일 여아가 열 및 발진으로 응급실을 방문하여 패혈증 및 다형홍반을 의심했지만, 상기 질환으 로 최종 진단한 증례를 경험했다. 본 증례는 열 및 발진을 동반한 3개월 미만 영아의 감별진단에 이 질환을 포함해 야 한다는 시사점이 있어, 이를 문헌고찰과 함께 보고한 열과 발진을 주소로 응급실을 방문한 47일 여아에서 진단된 신생아 루푸스","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80022975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-01DOI: 10.22470/pemj.2020.00136
Y. J. Kim, Yong Hyuk Kim
While diabetic ketoacidosis (DKA) is a major cause of morbidity and mortality of type 1 diabetes mellitus, recent studies have shown that 12%-56% of DKA cases occur in adults with type 2 diabetes mellitus (T2DM). Such cases are usually characterized by obese patients with family history of T2DM who show severe hyperglycemia and ketoacidosis. This specific form is termed ketosis-prone 2형 당뇨병을 처음 진단받은 14세 여자 환자에서 발생한 좌측 넓적다리동맥의 의인 혈전증을 동반한 당뇨병케토산증 및 고삼투질비케토산혼수 증례
While diabetic ketoacidosis (DKA) is a major cause of morbidity and mortality of type 1 diabetes mellitus;recent studies have shown that 12%-56% of DKA cases occur in adults with type 2 diabetes mellitus (T2DM)。Such cases are usually characterized by obese patients with family history of T2DM who show severe hyperglycemia and ketoacidosis。This specific form is termed ketosis-prone 2型糖尿病首次被诊断为糖尿病的14岁女性患者发生了左大腿动脉的人血栓同时伴有糖尿病酮症酸症及高渗透性鼻酸昏睡症
{"title":"A case of diabetic ketoacidosis and hyperosmolar hyperglycemic state complicated with iatrogenic left femoral arterial thrombosis in a 14-year-old girl with newly diagnosed type 2 diabetes mellitus","authors":"Y. J. Kim, Yong Hyuk Kim","doi":"10.22470/pemj.2020.00136","DOIUrl":"https://doi.org/10.22470/pemj.2020.00136","url":null,"abstract":"While diabetic ketoacidosis (DKA) is a major cause of morbidity and mortality of type 1 diabetes mellitus, recent studies have shown that 12%-56% of DKA cases occur in adults with type 2 diabetes mellitus (T2DM). Such cases are usually characterized by obese patients with family history of T2DM who show severe hyperglycemia and ketoacidosis. This specific form is termed ketosis-prone 2형 당뇨병을 처음 진단받은 14세 여자 환자에서 발생한 좌측 넓적다리동맥의 의인 혈전증을 동반한 당뇨병케토산증 및 고삼투질비케토산혼수 증례","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75145871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although most neonates will not require resuscitation, emergency clinicians must be prepared to manage neonates who require respiratory assistance. This issue reviews current expert recommendations and consensus updates of the best practices in resuscitation of neonates. An overview of neonatal physiology provides a framework for understanding how neonatal resuscitation differs from that of children and adults. A step-wise, systematic approach is provided for identifying and managing newborns who require resuscitation. The treatment, management, and over-arching goals for neonatal resuscitation and newborn care are also reviewed.
{"title":"Neonatal resuscitation in the emergency department.","authors":"Andrea T Vo, Christine S Cho","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although most neonates will not require resuscitation, emergency clinicians must be prepared to manage neonates who require respiratory assistance. This issue reviews current expert recommendations and consensus updates of the best practices in resuscitation of neonates. An overview of neonatal physiology provides a framework for understanding how neonatal resuscitation differs from that of children and adults. A step-wise, systematic approach is provided for identifying and managing newborns who require resuscitation. The treatment, management, and over-arching goals for neonatal resuscitation and newborn care are also reviewed.</p>","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"17 12","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38623437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-25DOI: 10.22470/pemj.2020.00115
Youn Ju An, S. Paek, O. Kim, J. A. Kim, J. Kwon, M. J. Kim
Purpose: This study was performed to investigate the gender differences in suicide attempts in adolescents. Methods: We reviewed the medical records of adolescents (≤ 18 years) who had visited a university hospital emergency department (ED) for suicide attempts from January 2018 through December 2019. General characteristics of the adolescents, details of the attempt, and outcomes were analyzed. The characteristics were age, gender, the Korean Triage and Acuity Scale, previous attempts, and psychiatric history. The details were initial Glasgow Coma Scale, attempt-arrival time, living alone, method, place, and motivation of the attempt, and concurrent use of alcohol. The outcomes included psychiatric consultation, ED length of stay, and ED outcomes. Results: A total of 86 adolescents were included. Their age ranged from 13 to 18 years, and girls accounted for 65.1%. The girls had more frequent psychiatric history than boys (66.1% vs. 30.0%; P = 0.001) without a significant difference in previous attempts (55.4% vs. 46.7%; P = 0.442). The most common methods of the attempt in the girls and boys were poisoning and sharp objects (53.3% [16 of the 30 boys] vs. 60.7% [34 of the 56 girls]; P = 0.002), respectively. No differences were found in the other details of the attempt and in the rate of psychiatric consultation. The girls had a longer ED length of stay (247.0 minutes vs. 186.5; P = 0.033), a lower rate of discharge against medical advice, and higher rates of hospitalization (discharge against medical advice, 53.6% vs. 76.7%; non-psychiatric, 23.2% vs. 3.3%; psychiatric, 12.5% vs. 0%; P = 0.003). Conclusion: Girls may make suicide attempts, usually by poisoning, and undergo relevant hospitalization, more often than boys. In contrast, boys usually use sharp objects, with a higher rate of discharge against medical advice and lower rates of the attempt and hospitalization.
目的:探讨青少年自杀倾向的性别差异。方法:我们回顾了2018年1月至2019年12月在某大学医院急诊科(ED)就诊的青少年(≤18岁)自杀未遂的医疗记录。分析青少年的一般特征、尝试的细节和结果。特征包括年龄、性别、韩国分诊和敏锐度量表、既往尝试和精神病史。细节包括最初的格拉斯哥昏迷量表、企图到达时间、独自生活、企图的方法、地点和动机以及同时使用酒精。结果包括精神科咨询、急诊科住院时间和急诊科结果。结果:共纳入86名青少年。年龄在13 - 18岁之间，女孩占65.1%。女孩比男孩有更频繁的精神病史(66.1%比30.0%;P = 0.001)，之前的尝试无显著差异(55.4% vs. 46.7%;P = 0.442)。女生和男生最常见的自杀方式是投毒和利器自杀，分别占53.3%(30例男生中16例)和60.7%(56例女生中34例);P = 0.002)。在企图自杀的其他细节和精神病学咨询的比率方面没有发现差异。女孩ED停留时间较长(247.0分钟vs 186.5分钟;P = 0.033)，不遵医嘱出院率较低，住院率较高(不遵医嘱出院，53.6% vs. 76.7%;非精神科，23.2% vs. 3.3%;精神科，12.5%对0%;P = 0.003)。结论:女孩可能有自杀企图，通常是中毒，并接受相应的住院治疗，比男孩多。相比之下，男孩通常使用尖锐物品，不遵医嘱出院的比率较高，尝试和住院的比率较低。
{"title":"Gender differences in characteristics of adolescents with suicide attempt at the emergency department","authors":"Youn Ju An, S. Paek, O. Kim, J. A. Kim, J. Kwon, M. J. Kim","doi":"10.22470/pemj.2020.00115","DOIUrl":"https://doi.org/10.22470/pemj.2020.00115","url":null,"abstract":"Purpose: This study was performed to investigate the gender differences in suicide attempts in adolescents. Methods: We reviewed the medical records of adolescents (≤ 18 years) who had visited a university hospital emergency department (ED) for suicide attempts from January 2018 through December 2019. General characteristics of the adolescents, details of the attempt, and outcomes were analyzed. The characteristics were age, gender, the Korean Triage and Acuity Scale, previous attempts, and psychiatric history. The details were initial Glasgow Coma Scale, attempt-arrival time, living alone, method, place, and motivation of the attempt, and concurrent use of alcohol. The outcomes included psychiatric consultation, ED length of stay, and ED outcomes. Results: A total of 86 adolescents were included. Their age ranged from 13 to 18 years, and girls accounted for 65.1%. The girls had more frequent psychiatric history than boys (66.1% vs. 30.0%; P = 0.001) without a significant difference in previous attempts (55.4% vs. 46.7%; P = 0.442). The most common methods of the attempt in the girls and boys were poisoning and sharp objects (53.3% [16 of the 30 boys] vs. 60.7% [34 of the 56 girls]; P = 0.002), respectively. No differences were found in the other details of the attempt and in the rate of psychiatric consultation. The girls had a longer ED length of stay (247.0 minutes vs. 186.5; P = 0.033), a lower rate of discharge against medical advice, and higher rates of hospitalization (discharge against medical advice, 53.6% vs. 76.7%; non-psychiatric, 23.2% vs. 3.3%; psychiatric, 12.5% vs. 0%; P = 0.003). Conclusion: Girls may make suicide attempts, usually by poisoning, and undergo relevant hospitalization, more often than boys. In contrast, boys usually use sharp objects, with a higher rate of discharge against medical advice and lower rates of the attempt and hospitalization.","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80000849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-16DOI: 10.22470/pemj.2020.00122
Jin ho Kim, K. Cho, Min Sun Kim, Sun Jun Kim
{"title":"A case of diabetic ketoacidosis with posterior cerebral artery territory ischemic stroke mimicking uncal herniation","authors":"Jin ho Kim, K. Cho, Min Sun Kim, Sun Jun Kim","doi":"10.22470/pemj.2020.00122","DOIUrl":"https://doi.org/10.22470/pemj.2020.00122","url":null,"abstract":"","PeriodicalId":38199,"journal":{"name":"Pediatric emergency medicine practice","volume":"116 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79859657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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