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1.
J AAPOS ; 28(2): 103864, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38458597

RESUMO

PURPOSE: To assess the impact of the COVID-19 pandemic on infant and toddler ocular trauma in the United States. METHODS: This retrospective analysis of ocular injury data for children ≤3 years of age focused on epidemiologic trends in pediatric ocular injuries in the United States caused by consumer products from 2017 to 2021 and compared differences between pre-pandemic (2017-2019) and pandemic (2020-2021) time periods. Data were collected from the US Consumer Product Safety Commission National Electronic Injury Surveillance System, which includes emergency department visits caused by consumer product-related injuries from a nationally representative sample of hospitals. RESULTS: The national-level estimate of ocular injuries in infants and toddlers was 51,250 (95% CI, 30471-72030). Most injuries occurred at home. We found a significant decline in the proportion of projectile ocular injuries from 0.89% (95% CI, 0.35-2.25) to 0.12% (95% CI, 0.03-0.45) (P = 0.037). The proportion of patients diagnosed with chemical-burn-related injuries increased significantly, from 23.34% (95% CI, 19.73-27.38) in the pre-pandemic period to 31.63% (95% CI, 26.98-36.69) in the pandemic period (P = 0.048), with 71.75% (95% CI, 65.25-77.46) due to cleaning products. After adjusting for confounding variables, the odds of sustaining a chemical-burn-related injury in the post-pandemic period were 1.51 times higher than in the pre-pandemic period (95% CI, 1.10-2.08). CONCLUSIONS: The proportion of children diagnosed with chemical-burn-related injuries increased significantly in the post-pandemic period, with a large portion due to cleaning products.


Assuntos
Queimaduras Químicas , COVID-19 , Traumatismos Oculares , Lactente , Criança , Humanos , Pré-Escolar , Estados Unidos/epidemiologia , Pandemias , Estudos Retrospectivos , COVID-19/epidemiologia , Traumatismos Oculares/epidemiologia , Queimaduras Químicas/epidemiologia , Serviço Hospitalar de Emergência
2.
Indian J Ophthalmol ; 71(7): 2694-2703, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37417107

RESUMO

Purpose: To study and compare the demographic and clinical profile of acute ocular burns (AOB) in children and adults. Methods: This retrospective case series included 271 children (338 eyes) and 1300 adults (1809 eyes) who presented to two tertiary eye care centers within one month of sustaining AOB. Data regarding demographics, causative agents, severity of injury, visual acuity (VA), and treatment were collected and analyzed. Results: Males were more commonly affected particularly among adults (81% versus 64%, P < 0.00001). Among children, 79% sustained domestic injuries, whereas 59% of adults had work-place injuries (P < 0.0001). Most cases were due to alkali (38%) and acids (22%). Edible lime (chuna, 32%), superglue (14%), and firecrackers (12%) in children, and chuna (7%), insecticides, lye, superglue (6% each), toilet cleaner (4%) and battery acid (3%) in adults, were the main causative agents. The percentage of cases with Dua grade IV-VI was greater in children (16% versus 9%; P = 0.0001). Amniotic membrane grafting and/or tarsorrhaphy were needed in 36% and 14% of affected eyes in children and adults, respectively (P < 0.00001). The median presenting VA was logMAR 0.5 in children and logMAR 0.3 in adults (P = 0.0001), which improved significantly with treatment in both groups (P < 0.0001), but the final VA in eyes with Dua grade IV-VI burns was poorer in children (logMAR 1.3 versus logMAR 0.8, P = 0.04). Conclusion: The findings clearly delineate the at-risk groups, causative agents, clinical severity, and treatment outcomes of AOB. Increased awareness and data-driven targeted preventive strategies are needed to reduce the avoidable ocular morbidity in AOB.


Assuntos
Queimaduras Químicas , Doenças da Córnea , Transplante de Córnea , Queimaduras Oculares , Limbo da Córnea , Masculino , Criança , Adulto , Humanos , Queimaduras Oculares/diagnóstico , Queimaduras Oculares/epidemiologia , Queimaduras Oculares/cirurgia , Estudos Retrospectivos , Queimaduras Químicas/diagnóstico , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/cirurgia , Ácidos , Demografia
3.
BMJ Open Ophthalmol ; 8(1)2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-37278423

RESUMO

BACKGROUND: The current study aimed to analyse epidemiological data on eye burns in Wuxi, China, for the years 2015-2021, and to provide insight into the development of appropriate prevention strategies. METHODS: A retrospective study was conducted on 151 hospitalised patients with eye burns. Data collected included gender, age, the monthly distribution of incidence, cause of eye burn, the site of eye burn, the type of surgery, visual outcome, the length of hospital stay and the cost of hospital admission. Statistical analysis was performed using SPSS V.19.0 and Graph Pad Prism V.9.0. RESULTS: In a total of 151 eye burn patients, 130 were males (86.09%) and 21 were females (13.91%). The proportion of patients classified as grade III was the greatest (46.36%). The average age of our hospitalised patients with eye burns was 43.72 years and the average length of hospital stay was 17 days. The number of injuries was highest in September (14.6%). Among eye burn patients, workers and farmers became the most common occupations (62.91%, 12.58%). The most frequent cause of burns was alkali burns (19.21%), followed by acid burns (16.56%). When admitted to the hospital, patients' average vision was 0.06, and 49% of them had a poor vision (<0.3, ≥0.05). CONCLUSION: With an investigation of 7-year hospitalisation data, the current study provided a fundamental reference for epidemiological features and management of eye burns in Wuxi, China, which could contribute to the development of treatment and prevention strategies.


Assuntos
Queimaduras Químicas , Queimaduras Oculares , Masculino , Feminino , Humanos , Adulto , Estudos Retrospectivos , Queimaduras Químicas/epidemiologia , Queimaduras Oculares/epidemiologia , Hospitalização , China/epidemiologia
4.
Burns ; 49(7): 1729-1732, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37003848

RESUMO

BACKGROUND: Household cleaning and personal care products (HC&PCPs) are irreplaceable in most daily routines. However, data are sparse on chemical burns caused by HC&PCPs. METHODS: We queried the National Electronic Injury Surveillance System (NEISS) from 2012 to 2021 to characterize chemical burns caused by HC&PCPs as well as the most common causative categories of HC&PCPs responsible for chemical burns. RESULTS: We found 2729 total emergency department (ED) visits due to chemical burn injuries within the years 2012-2021 due to HC&PCPs. Chemical burns disproportionally affect children ages four and under, accounting for 36.4% of all patients. Within this subpopulation, boys were more frequently affected by chemical burns and the eyes were the most affected area. The most common HC&PCPs involved in chemical burns in individuals ages one to four were laundry soaps and detergents (22.0%) and bleaches (21.3%). CONCLUSION: Children ages four and under are disproportionately affected by chemical burns due to non-intentional exposure of HC&PCPs, with laundry detergents and bleaches being the most common causative agents. Adequate storage of all HC&PCPs and improved parental supervision are paramount in preventing chemical burns in this age group.


Assuntos
Queimaduras Químicas , Detergentes , Masculino , Criança , Humanos , Detergentes/efeitos adversos , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Estudos Transversais , Sabões , Serviço Hospitalar de Emergência
5.
Int Wound J ; 20(7): 2788-2794, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36931904

RESUMO

The etiology and outcomes of chemical burns vary worldwide, influenced by the local population structure, industry distribution, and geographical and social environments. The aim of this study was to evaluate the epidemiology of chemical burns among patients referred to a burn centre in the north of Iran. A single-centre, retrospective study was conducted on patients with chemical burns between 2011 and 2021. Data collection was carried out using the hospital information system (HIS), and data collected from medical records included gender, age, marital status, occupations, burn season, place of residence, intention to burn, location of the accident, percent of total body surface area (%TBSA), the primary cause of burns, the body region of the burn, length of hospital stay (days), infection, and discharge status. The data were analysed using descriptive statistical methods and SPSS 24.0 software. Of the 10 133 burn patients treated in a burn centre in the north of Iran between 2011 and 2021, 1.2% had chemical burns. The average age of patients was 34.45 (SD = 22.16) years, and most chemical burns cases were male (70.6%, n = 89). Chemical burns occurred most frequently in patients aged 20 to 49 years (69.8%, n = 107), and most of the burns were accidental (84.9%, n = 107). The home was the most common place of chemical burn injury, accounting for 49.2% (62 cases), followed by the workplace (43.7%, n = 55), respectively. Most chemical burns occurred in the summer season (36.5%, n = 46), and acid (74.6%, n = 94) was the most common cause of chemical burns. The mean TBSA was 16.41 (SD = 15.10). The most common burn area was the lower limb (34.9%, n = 44), and the overall mortality rate was 4.8%. The average length of stay in the hospital was 6.53 (SD = 5.57) days. Community education on household safety, restricting non-specialists' access to chemical substances, and the promotion of early consultation could reduce chemical burn prevalence and improve outcomes.


Assuntos
Queimaduras Químicas , Humanos , Masculino , Adulto , Feminino , Estudos Retrospectivos , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Unidades de Queimados , Irã (Geográfico)/epidemiologia , Tempo de Internação , Encaminhamento e Consulta
6.
J Plast Reconstr Aesthet Surg ; 76: 208-215, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36527902

RESUMO

PURPOSE: Ocular burns are ophthalmic emergencies that can cause devastating injuries. This study aimed to analyze the epidemiology, complications, and management of ocular-periocular burns. METHODS: A total of 193 patients with ocular-periocular burns were admitted to our tertiary hospital from January 2018 to December 2020. The demographic characteristics of the patients, injury variables, complications, and treatments were evaluated. RESULTS: There were 142 male (73.6%) and 51 female (26.4%) patients with a mean age of 32.53±17.75 years. The average total body surface area was 12% (range, 1-80%). Injuries were most common at work (52.3%) and home (36.3%). Thermal burns were the most common injuries (74.6%), followed by chemical (14.5%) and electrical burns (10.9%). Alkaline agents (75.0%), mainly sodium hydroxide and lime, were common in chemical burns. Superficial lid burns were significantly higher in the thermal group (p < 0.001), and grade III-IV corneal burns were significantly higher in the chemical group (p < 0.001). Various complications were developed in 50 (13%) eyes. Medical treatment only was performed in 318 (82.4%) eyes, and additional surgical treatment was performed in 64 (17.6%) eyes; however, 54 (14.0%) underwent more than one surgery. The most common complications were corneal scars (7.3%), limbal deficiency (4.1%), and ectropion (3.9%). The most frequent procedures performed were amniotic membrane transplantation (AMT) (11.9%) and tarsorrhaphy (6.7%). CONCLUSION: Chemical burns, limbal and conjunctival ischemia, and full-thickness eyelid defects had a poor prognosis. The degree of limbal deficiency and injury of intraocular structures were found to have a great influence on the outcome of their visual acuity.


Assuntos
Queimaduras Químicas , Lesões da Córnea , Queimaduras Oculares , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Queimaduras Oculares/epidemiologia , Queimaduras Oculares/etiologia , Queimaduras Oculares/terapia , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Queimaduras Químicas/terapia , Centros de Atenção Terciária , Túnica Conjuntiva
7.
Arch Pediatr ; 29(8): 573-580, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36210236

RESUMO

BACKGROUND AND AIMS: The ingestion of caustic substances remains a serious medical problem in Tunisian children. This study was conducted to describe the epidemiological, clinical, and endoscopic findings of caustic ingestion in Tunisian children, and to indentify predictive factors of severe esophageal and gastric injuries. PATIENTS AND METHODS: A retrospective review of all children referred to a tertiary pediatric center for caustic ingestion who underwent esophago-gastro-duodenoscopy was conducted. Severe esophageal and gastric injuries were defined as Grade 2b, 3a, 3b, and 4 using the Zargar classification. We conducted multivariate logistic regression analysis to identify predictive factors for severe esophageal and gastric caustic injuries. RESULTS: We analyzed 1059 diagnostic procedures performed for caustic ingestion. The mean age was 41.4± 31.9 months. The most frequently ingested caustic substance was household bleach followed by caustic soda granules. Endoscopy showed severe esophageal and gastric lesions, respectively, in 122 (11.5%) and 56 (5.3%) cases. Predictive factors of severe esophageal injuries were: alkaline ingestion (p<0.001; OR: 17.9; 95% CI: 8.4-38.1) and the presence of symptoms after caustic ingestion (p=0.02; OR: 2.4; 95% CI: 1.1-5.4). The occurrence of complications was significantly associated with the presence of severe gastric lesions at the initial procedure (p=0.046; OR: 2.3;95% CI: 0.9- .3). CONCLUSION: Esophago-gastro-duodenoscopy should always be performed for symptomatic children, asymptomatic children who have ingested an alkaline product, and asymptomatic children under the age of 6 years.


Assuntos
Queimaduras Químicas , Cáusticos , Estenose Esofágica , Criança , Humanos , Lactente , Pré-Escolar , Cáusticos/toxicidade , Queimaduras Químicas/diagnóstico , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Esôfago/lesões , Estudos de Coortes , Estudos Retrospectivos , Ingestão de Alimentos , Estenose Esofágica/induzido quimicamente , Estenose Esofágica/epidemiologia
8.
Pediatr Surg Int ; 38(3): 505-512, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34999939

RESUMO

PURPOSE: Considering that clinical presentation and gastrointestinal tract (GIT) injuries post-caustic ingestion vary in children, this study aims to establish whether a correlation exists between clinical presentation and endoscopic findings. METHODS: This retrospective study comprised patients referred to a paediatric surgical unit between 2016 and 2018 within 72 h post-caustic ingestion. Data collected included caustic agents ingested, clinical presentation, endoscopic findings and management. Oesophageal injuries were graded according to the Zargar's endoscopic classification and gastric injuries classified as mild to severe. RESULTS: Fifty patients with a mean age of 2.4 years were managed during the study period. Potassium permanganate (KMNO4) was the most frequently ingested substance in 27 (54%) patients. All 30 (60%) asymptomatic patients had no positive endoscopic findings regardless of clinical signs. Among the symptomatic patients (n = 20), 15 (75%) had oesophageal injuries (p = 0.01). Stridor was associated with a higher grade of oesophageal injury (p = 0.007). CONCLUSIONS: Clinical signs and symptoms post-caustic ingestion correlated with endoscopic findings in our study. Endoscopy can be safely omitted in asymptomatic patients, including those with isolated staining secondary to KMNO4 ingestion. Symptomatic patients should have an endoscopy performed within 48-72 h of the insult to diagnose injuries.


Assuntos
Queimaduras Químicas , Cáusticos , Estenose Esofágica , Queimaduras Químicas/diagnóstico , Queimaduras Químicas/epidemiologia , Cáusticos/toxicidade , Criança , Pré-Escolar , Ingestão de Alimentos , Endoscopia Gastrointestinal , Humanos , Estudos Retrospectivos , África do Sul/epidemiologia
10.
Pediatr Neonatol ; 62(6): 638-646, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34332912

RESUMO

BACKGROUND: Poisoning by household cleaning products(HCPs) is common in children. Some HCPs are toxic and may cause severe complications. We assessed HCP poisonings treated in a pediatric emergency department(PED). METHODS: This was a retrospective study of patients aged under 18 years with HCP poisoning admitted to the largest PED in Taiwan from 2011 to 2020 were recruited. RESULTS: The records over a 10-year period from 103 children admitted to the PED because of HCP poisoning(70 boys [68%] and 33 girls [32%]), mean age 3.54 years(standard deviation [SD] = 3.15 years) were evaluated. Most poisonings were unintentional(99%, n = 102) and occurred at home(96%, n = 99). The HCPs included alkaline(74%, n = 76), acidic(25%, n = 26), and neutral(1%, n = 1) agents. Most were orally ingested(86%, n = 89). Panendoscopy was performed in 25 patients(24%), and the endoscopic(Zargar) grade was used to determine the severity of injury. Medications(steroids [9%, n = 9], antibiotics [10%, n = 10], or antacids [30%, n = 23]) were prescribed. Alkaline HCP ingestion induced severe esophageal injury(p = 0.04) and esophageal stricture(p = 0.04). Five patients(5%) exhibited esophageal strictures and required balloon dilation. On multivariate analysis, alkaline HCP ingestion(p = 0.04), severe esophageal caustic injury(Zargar grade ≥ 3) (p < 0.001), and medications(steroids [p < 0.001], antibiotics [p < 0.001], and antacids [p = 0.001]) were associated with esophageal stricture. CONCLUSION: Alkaline HCP ingestion and severe esophageal caustic injury(Zargar grade ≥ 3) were associated with esophageal stricture. Physicians tended to prescribe medications(steroids, antibiotics, or antacids) for patients with severe esophageal injuries to reduce the risk of esophageal stricture. The usefulness of these medications requires further study.


Assuntos
Queimaduras Químicas , Cáusticos , Estenose Esofágica , Adolescente , Idoso , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Queimaduras Químicas/terapia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
12.
J Formos Med Assoc ; 120(10): 1907-1913, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33422399

RESUMO

BACKGROUND: Ingestion of alkaline substances should not be disregarded because a small amount can cause chemical burns in the esophagus, with esophageal stricture being the most common late complication. METHODS: We enrolled children with alkaline corrosive damage receiving treatment at China Medical University Children's Hospital's emergency department between 2008 and 2018. Patients were divided into groups A (ingested causative agents other than alkaline oil), and B (ingested alkaline oil). RESULTS: Altogether, 40 (27 [67.5%] male and 13 [32.5%] female) patients aged 7 months-7 years were enrolled. The most commonly ingested agent was alkaline oil (13 cases, 32.5%), followed by oven and drainage cleaners (8 cases, 20%), bleach (6 cases, 15%), laundry and dish cleaners (4 cases, 10%), sodium hydroxide (4 cases, 10%), sodium carbonate (2 cases, 5%), sodium phosphate (2 cases, 5%), and sodium citrate (1 case, 2.5%). High proportions of children had esophagitis (40/40, 100%), erosive gastritis (7/40, 17.5%), and gastric ulcer (6/40, 15%). The incidence of esophageal stricture was 38.4% (5/13) and 7.4% (2/27) in groups B and A, respectively. In group B, 4 children developed growth stunting or malnutrition during the first decade after onset, with reduced immunity and feelings of inferiority. CONCLUSION: Alkaline ingestion usually results in esophageal injury that is difficult to cure. Corrosive esophageal strictures cause swallowing difficulties and growth stunting in children. Young children who ingested alkaline oil have more complications. Given that alkaline corrosive injuries are often accidental, prevention of corrosive agent ingestion is crucial.


Assuntos
Queimaduras Químicas , Cáusticos , Estenose Esofágica , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Cáusticos/toxicidade , Criança , Pré-Escolar , Estenose Esofágica/induzido quimicamente , Estenose Esofágica/epidemiologia , Feminino , Hábitos , Humanos , Masculino
14.
Int J Occup Saf Ergon ; 27(3): 817-830, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31251122

RESUMO

Purpose. This article attempts to elucidate the nature of chemicals causing major and minor skin burns, and their associated characterization across different industries, using Fujian provincial hospitals' admission and outpatient department records. Materials and methods. Data were collected from the provincial hospitals of Fujian through a questionnaire, sent via email, from June 1, 2017 to November 30, 2017. The collected responses were statistically analyzed using SPSS version 19 through the interquartile range, median, Mann-Whitney U test and Fisher's exact test with two-tailed significance. Results and conclusions. The results of 306 collected responses reveal that the majority of skin burn cases are due to a lack of technical education and professional training among workers handling chemicals. This study suggests that management's effective supervision and governmental regulations may help to prevent chemical skin burns at work, and can further be controlled by hiring professional workers alongside providing training to them in chemical handling as well as using protective equipment and developing appropriate management policies to improve victims' well-being and quality of life. Findings will help workers, doctors, hospitals, industries, government and other stakeholders to understand and control chemical hazards on site to minimize the risks of chemical skin burn incidents.


Assuntos
Queimaduras Químicas , Pacientes Ambulatoriais , Queimaduras Químicas/epidemiologia , Hospitalização , Humanos , Qualidade de Vida , Inquéritos e Questionários
15.
Indian J Ophthalmol ; 69(1): 58-64, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33323574

RESUMO

Purpose: To evaluate the outcomes of early amniotic membrane transplant (AMT) in acute ocular surface burns using Dua's classification. Methods: In this retrospective analysis conducted at a tertiary eye care center in Western India. We included 27 eyes of 24 patients from May 2014 to May 2019 who underwent AMT within 2 weeks post insult along with medical treatment for acute ocular surface burns using Dua's classification for grading on presentation. Post-operative assessment for ocular surface epithelization, corneal vascularization, symblepharon formation, and visual outcome at the time of complete epithelization was done. Results: Eight, seven, three, and nine eyes with grade III, IV, V, and VI, respectively, were included in the study. The mean duration of the presentation was 5.5 ± 3.6 days, with the mean follow-up of 4.83 ± 2.2 months. Alkali burn (62.96%, 17/27 eyes) was the commonest. The mean epithelization time was 5.80 ± 2.92 weeks. Corneal vascularization for >6 clock hours was seen in 52.38% (11/21 eyes with vascularization). Symblepharon was seen in 55.55% (15/27 eyes). Vision improvement and corneal vascularization to a lesser extent (<6 clock hours) was observed in Group A (grades III and IV) as compared to group B (grades V and VI) and found to be significant (P-value = 0.031, P value = 0.007, respectively). Conclusion: Amniotic membrane grafting is a useful aid in moderate grades of acute ocular surface burns with an important adjunct role in severe cases.


Assuntos
Queimaduras Químicas , Doenças da Córnea , Queimaduras Oculares , Âmnio/transplante , Queimaduras Químicas/diagnóstico , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/cirurgia , Doenças da Córnea/diagnóstico , Doenças da Córnea/epidemiologia , Doenças da Córnea/cirurgia , Queimaduras Oculares/diagnóstico , Queimaduras Oculares/epidemiologia , Queimaduras Oculares/cirurgia , Humanos , Índia/epidemiologia , Estudos Retrospectivos
16.
Rev Esp Enferm Dig ; 113(4): 272-275, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33222476

RESUMO

INTRODUCTION: caustic ingestion in children is rare but has potentially serious consequences. AIM: to analyze the clinical and endoscopic features and the type of caustic ingested in our population. METHODS: the upper endoscopies performed in this setting, as well as the characteristics of patients and caustics, were analyzed from 2010 to 2018. RESULTS: fifty-one endoscopies were performed (48 cases of witnessed intake or high suspicion and three with a low suspicion) in patients with a mean age of 2.55 years. Alkali ingestion was more frequent (88.2 %) and 56.9 % of the endoscopies were normal, which was more frequent among those who ingested bleach (72 %). Alkali tended to produce more esophageal injuries (31.1 %) and acids tended to produce esophageal (20 %) and esophageal-gastric injuries (20 %). Four patients developed esophageal stenosis during follow-up. DISCUSSION: even though more than half of the studies were normal, endoscopy is important in the diagnosis and prognosis of these patients.


Assuntos
Queimaduras Químicas , Cáusticos , Estenose Esofágica , Queimaduras Químicas/diagnóstico por imagem , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Cáusticos/toxicidade , Criança , Pré-Escolar , Ingestão de Alimentos , Endoscopia , Estenose Esofágica/induzido quimicamente , Estenose Esofágica/diagnóstico por imagem , Humanos
17.
Afr J Paediatr Surg ; 17(3 & 4): 74-78, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33342838

RESUMO

BACKGROUND: Corrosive ingestion in children occurs usually at home and frequently results in debilitating strictures. Prevention and early intervention programs are very important for good outcomes. AIMS AND OBJECTIVES: This study aims at examining the immediate causative factors and problems of this subset of patients with a special focus on treatment and outcome. This study was to audit the management of patients in the paediatric age group who presented for treatment with history and sequelae of corrosive ingestion seen by the cardiothoracic unit of the University of Benin Teaching Hospital from January 2005 till December 2018. MATERIALS AND METHODS: This is a 14year retrospective study of patients that presented with oesophageal burn injuries from ingestion of corrosive agents to the Cardiothoracic Unit at the University of Benin Teaching Hospital between January 2005 and December 2018. Essentially the first 5years were retrospectively included but the subsequent years were prospective. All available medical data on these patients were retrieved and studied for epidemiological, clinical and operative procedures and outcome. RESULTS: A total of 49 patients were seen and admitted during the period under review. Male (29) : Female (20) ratio was 1:1.4 Mean age was 4.7±4.8 years with a range of 1-16years, The males presented earlier and had worse strictures as well as more surgical procedures. Caustic soda preparations ingested more (93.9%), all ingestions were within the household setting, and all had first aid given by way of oral palm oil. Only two (4.1%) ingested acids with only one flat battery ingestion. 45.5% of the patients had dilatation only and of these 50% recovered after 3 sessions and required no more sessions. A further 50% were lost to follow up. 38.8% had oesophageal replacement with colon following oesophagectomy. CONCLUSION: In conclusion, corrosive oesophageal stricture is a debilitating disease in children and affects males more, but it is treatable by multiple dilatations and oesophageal replacement with colon. Prevention should be actively pursued as well as early intervention.


Assuntos
Queimaduras Químicas/terapia , Gerenciamento Clínico , Estenose Esofágica/terapia , Esôfago/lesões , Previsões , Adolescente , Queimaduras Químicas/complicações , Queimaduras Químicas/epidemiologia , Cáusticos/efeitos adversos , Criança , Pré-Escolar , Dilatação/métodos , Estenose Esofágica/epidemiologia , Estenose Esofágica/etiologia , Esôfago/diagnóstico por imagem , Feminino , Seguimentos , Hospitais de Ensino , Humanos , Incidência , Lactente , Masculino , Nigéria/epidemiologia , Estudos Retrospectivos
18.
BMJ Open ; 10(10): e038109, 2020 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-33077563

RESUMO

OBJECTIVES: To understand the incidence, causes, management and outcomes of intentional (assault) and unintentional severe ocular chemical injuries (SOCI) at an urban tertiary referral centre in the UK. DESIGN: Retrospective observational study. SETTING: A London tertiary referral ophthalmic centre, Moorfields Eye Hospital. PARTICIPANTS: All cases of SOCI presenting between 1 September 2011 and 31 August 2014 were identified. The definition of SOCI was grade 3 or 4 on the Hughes-Roper-Hall classification system. We identified 25 cases (6 in 2011-2012, 8 in 2012-2013, 11 in 2013-2014). Median age was 31.1 years. 23 cases (92%) were male. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the proportion of cases of SOCI caused by assault, per year. Secondary outcome measures included the number of cases of SOCI, injury characteristics and mechanism, initial and long-term management, visual outcome and the need for surgical intervention. RESULTS: Between 2011 and 2012, 3/6 cases were due to assault (50%); between 2012 and 2013, 7/8 were due to assault (87.5%); and between 2013 and 2014, 6/11 were due to assault (54.4%). Assault was responsible for 16/25 (64%) cases overall, while 8/25 (32%) cases were work related. The causative agent was known to be alkali in 16/25 (64%), while 10/25 (40%) did not complete the follow-up. The mean number of clock hours of limbal ischaemia was 5.24 (SD 2.97). 17/25 (68%) were Hughes-Roper-Hall grade 3. Surgical intervention occurred in 1/25. The final best-corrected visual acuity was 6/12 or worse in 11/25 (44%) and was counting fingers or worse in 4/25 (16%). CONCLUSIONS: Previous studies found that SOCI had a low incidence and that work-related injuries were the most common cause. Our study demonstrates an increasing incidence of SOCI, which may be accounted for by a rise in assault using corrosive substances. A high number of patients did not attend regularly for follow-up and visual outcomes from these injuries are poor.


Assuntos
Queimaduras Químicas , Adulto , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Feminino , Humanos , Londres/epidemiologia , Masculino , Encaminhamento e Consulta , Estudos Retrospectivos , Acuidade Visual
19.
J Burn Care Res ; 41(6): 1188-1197, 2020 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-32353117

RESUMO

Liquefied petroleum gas (LPG) is a widely used environment-friendly fuel. Previous studies have shown an increasing number of LPG-related burns. Our study was designed to evaluate the epidemiologic pattern of these injuries and provide recommendations for burn prevention. This retrospective study included all patients with LPG-related burns from eight burn centers in Zhejiang Province, China between 2011 and 2015. Database variables included patient demographics, accident characteristics, and injury characteristics. The association between different categorical variables was identified using the chi-square test. And the association between two or more means of quantitative variables was analyzed by the one-way analysis of variance or t-test. A total of 1898 patients were included, 47.31% were males and 52.69% were females. The predominant age group was 31 to 70 years (74.50%), and the majority were poorly educated and the incidence peaked from June to September. The most common place of occurrence was home (74.08%) and gas leak (96.52%) was the most common cause. The four limbs (43.33%) were the most frequently affected areas; the mean burn area was 25.19 ± 20.97% of the total body surface area and most patients (46.89%) suffered from moderate burns. The mean length of hospital stay was 17.66 ± 16.55 days and the majority of patients (89.36%) recovered with a 0.84% mortality rate. Our findings reflected that the increase in incidence rate was alarming, and the causes resulting in LPG-related burns have not gained much attention yet. Therefore, this calls for simple but strict measures aiming at each hazardous step during the use of LPG to prevent these burn injuries.


Assuntos
Queimaduras Químicas/epidemiologia , Queimaduras Químicas/etiologia , Petróleo , Adulto , Idoso , Unidades de Queimados , Queimaduras Químicas/mortalidade , China/epidemiologia , Feminino , Gases , Humanos , Incidência , Escala de Gravidade do Ferimento , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
20.
Burns ; 46(5): 1225-1231, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32173069

RESUMO

INTRODUCTION: Burn injuries can present with catastrophic physical and psychiatric harm with extensive, long-term sequelae. The pediatric population may especially be at-risk given this population's early neurocognitive and behavioral state of development. Innovations in treatment modalities and the development of evidence-based guidelines have helped mitigate burn morbidity and mortality in the pediatric population. Unfortunately, a surprising dearth of literature identifies risk-factors, epidemiological data, injury mechanisms, and prognostic factors within the pediatric population in the setting of craniofacial burns. METHODS: An analysis of emergency department visits under the National Electronic Injury Surveillance System was conducted for the most recent 5-year period available (2014-2018). Available information includes demographical data, such as age and sex, mechanism of injury, visit circumstances, as well as visit disposition. Additionally, details surrounding the injury, including type of burn and anatomical location of injury, were compared. RESULTS: After a review of results, a total of 2599 patients were included for analysis. Our study shows that infants and young children are at increased risk for grave injury 27.3% and 13% of infants and toddlers transferred or admitted, respectively, p < 0.05). 59.8% of infant burns in particular were caused by liquid or kitchen products, while 44.5% of burns in toddlers were caused by chemical products (p < 0.05 for both). Conversely, adolescents are at greater risk of burns in the setting of occupational and hobby-based activities (20.4% of adolescent burns). CONCLUSIONS: Craniofacial burns in the pediatric population may present with complex pathology and sometimes necessitate advanced care. Presentations and prognoses are different dependent upon age and injury mechanism. These findings may serve as important framework in the establishment of guidelines for medical and legislative reform.


Assuntos
Queimaduras/epidemiologia , Traumatismos Craniocerebrais/epidemiologia , Traumatismos Faciais/epidemiologia , Lesões do Pescoço/epidemiologia , Adolescente , Distribuição por Idade , Fatores Etários , Queimaduras/terapia , Queimaduras Químicas/epidemiologia , Queimaduras Químicas/terapia , Queimaduras por Corrente Elétrica/epidemiologia , Queimaduras por Corrente Elétrica/terapia , Criança , Pré-Escolar , Traumatismos Craniocerebrais/terapia , Serviço Hospitalar de Emergência , Queimaduras Oculares/epidemiologia , Queimaduras Oculares/terapia , Traumatismos Faciais/terapia , Feminino , Incêndios , Hospitalização/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Lesões do Pescoço/terapia , Alta do Paciente , Transferência de Pacientes/estatística & dados numéricos , Couro Cabeludo/lesões , Queimadura Solar/epidemiologia , Queimadura Solar/terapia
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