RESUMO
Of 254 children who were 1 to 6 years of age and were tested at two major inner-city emergency departments, 65% had no record of previous lead screening in the previous 30 months, and 71% (97/137) and 50% (58/117), respectively, had blood lead levels > or = 0.48 mumol/L (10 micrograms/dl). The emergency department may be an appropriate resource for lead screening of selected inner-city children.
Assuntos
Intoxicação por Chumbo/prevenção & controle , Programas de Rastreamento/estatística & dados numéricos , Saúde da População Urbana , Criança , Pré-Escolar , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Hospitais Urbanos , Humanos , Lactente , Chumbo/sangue , Intoxicação por Chumbo/sangue , Intoxicação por Chumbo/epidemiologia , Masculino , Programas de Rastreamento/métodos , Philadelphia/epidemiologia , PrevalênciaRESUMO
The expression of cardiac dysfunction in pediatric patients with myocarditis may not be conspicuous. While older children with myocarditis may abruptly present with pleuritic or angina-like pain, infants and toddlers with fulminant disease are unable to verbalize such complaints. Cardiac compromise in preverbal children may only be inferred from variable examination findings that include gallop rhythm, tachycardia, malignant dysrhythmias, murmur, rub, and signs of congestive heart failure. The emergency physician is likely to overlook a cardiac origin for wheezing in a child with a past medical history of asthma. Therapeutic modalities chosen for reactive airway disease may adversely influence the outcome of a patient with myocarditis.
Assuntos
Miocardite/complicações , Sons Respiratórios/etiologia , Asma/diagnóstico , Diagnóstico Diferencial , Emergências , Humanos , Lactente , Masculino , Miocardite/diagnósticoRESUMO
Two cases of neonatal upper respiratory tract obstruction caused by herpes simplex virus are described. Infection of the upper respiratory tract with this virus should be included in the differential diagnosis of fever and stridor during the neonatal period.
Assuntos
Obstrução das Vias Respiratórias/etiologia , Herpes Simples/complicações , Infecções Respiratórias/complicações , Diagnóstico Diferencial , Epiglotite/etiologia , Feminino , Herpes Simples/transmissão , Humanos , Recém-Nascido , Laringite/etiologia , Masculino , Traqueíte/etiologiaRESUMO
A retrospective review was conducted of 22 human immunodeficiency virus type 1 (HIV-1)-infected children under 13 years of age presenting to an inner city pediatric emergency department to determine their clinical manifestations of disease and utilization of emergency department services. When compared with a population of 78 normal children, the infected children were more likely to present with cough, difficulty in breathing, and lethargy. Pneumonia, diarrhea, and dehydration were more common diagnoses in the infected children, who were more likely to be admitted, had more invasive procedures, and required more professional staff to provide care. There was no significant difference in the frequency of visits (visits/month of age) when comparing the two groups. As expected, the infected children presented with problems associated with pediatric HIV-1 infection. Our results suggest that HIV-1-infected children require an increased level of care in the emergency department and subsequent admission to the hospital. These children did not visit the emergency department more frequently than the controls. This may be the result of an active outpatient HIV clinic in our hospital, which is available to both scheduled and unscheduled patients.