RESUMO
Traumatic hip dislocations are rare in children, and reports of these injuries focus primarily on the risk of osteonecrosis of the femoral head as well as the long-term efficacy of treatment. Anatomical characteristics of the hip in young children, such as ligamentous laxity and a pliable acetabulum, can allow hip dislocation with low-energy trauma, but these injuries occur primarily in school-aged children during play activities. We report a hip dislocation in a 3-year-old child with no clear explanation of the mechanism of injury and with multiple unexplained bruises at different stages of healing that led to the diagnosis of nonaccidental trauma (NAT). This case highlights the need to consider NAT in young patients with a traumatic hip dislocation.
Assuntos
Maus-Tratos Infantis/diagnóstico , Luxação do Quadril/diagnóstico por imagem , Pré-Escolar , Luxação do Quadril/terapia , Humanos , Masculino , RadiografiaRESUMO
OBJECTIVE: The aim of this study was to assess health changes seen in routine homeopathic care for patients with a wide range of chronic conditions who were referred to a hospital outpatient department. DESIGN: This was an observational study of 6544 consecutive follow-up patients during a 6-year period. SETTING: Hospital outpatient unit within an acute National Health Service (NHS) Teaching Trust in the United Kingdom. PARTICIPANTS: Every patient attending the hospital outpatient unit for a follow-up appointment over the study period was included, commencing with their first follow-up attendance. MAIN OUTCOME MEASURE: Outcomes were based on scores on a 7-point Likert-type scale at the end of the consultation and were assessed as overall outcomes compared to the initial baseline assessments. RESULTS: A total of 6544 consecutive follow-up patients were given outcome scores. Of the patients 70.7% (n = 4627) reported positive health changes, with 50.7% (n = 3318) recording their improvement as better (+2) or much better (+3). CONCLUSIONS: Homeopathic intervention offered positive health changes to a substantial proportion of a large cohort of patients with a wide range of chronic diseases. Additional observational research, including studies using different designs, is necessary for further research development in homeopathy.