Three-year prevalence of self-harm behaviors among the reasons for emergency visits of children and adolescents.

Self-harm in the paediatric population is an emerging problem that has been associated with disability and an increased risk of suicide. The objective of the study is to analyse the prevalence of self-harming behaviour as a reason for paediatric emergency consultations.

Role of urine culture in paediatric patients with cancer with fever and neutropenia: a prospective observational study.

OBJECTIVE: To evaluate the need for routine urine studies in children with febrile neutropenia with cancer. DESIGN: A prospective, observational study was conducted in two hospitals between November 2019 and October 2021. PATIENTS: We recruited 205 patients in total. MAIN OUTCOME MEASURES: The primary outcome was presence of positive urine culture (UC). Urinary tract infection (UTI) was defined as urinary signs/symptoms and positive UC with or without pyuria. A descriptive analysis of data is provided.We conducted a prospective study of paediatric patients with cancer with urinary continence. Data were analysed using descriptive statistics. The diagnostic performance of urinalysis was calculated using positive UC as the gold standard. RESULTS: Positive UC was found in 7 of the 205 patients (3.4%; 95% CI 1.4% to 6.9%), 2 presenting urinary symptoms. UTI prevalence was 1.0% (95% CI 0.1% to 3.5%). A 23.8% prevalence of positive UC was found in patients with urinary symptoms and/or history of urinary tract disease (95% CI 8.2% to 47.2%) as compared with 1.1% of those without symptoms or history (95% CI 0.1% to 3.9%) (p<0.001). The sensitivity, specificity, negative predictive value, and area under the curve for urinalysis were 16.7% (95% CI 3.0% to 56.4%), 98.4% (95% CI 95.3% to 99.4%), 97.3% (95% CI 93.9% to 98.9%), and 0.65 (95% CI 0.51 to 0.79), respectively. CONCLUSIONS: UTI is an infrequent cause of infection in these patients. Urinalysis is indicated only in children with febrile neutropenia with urinary signs/symptoms and in asymptomatic patients with a history of urinary tract disease or unknown history. When urine is collected, UC should be requested regardless of the result of the urinalysis.

Prevalencia a 3 años de las conductas autolesivas entre los motivos de consulta a urgencias en población infantojuvenil / Three-year prevalence of self-harm behaviors among the reasons for emergency visits of children and adolescents

INTRODUCCIÓN: Las conductas autolesivas en población pediátrica son un problema emergente que se ha asociado a la discapacidad y un mayor riesgo de muerte por suicidio. El objetivo del estudio es analizar la prevalencia de las con­ductas autolesivas entre los motivos de consulta a urgencias pediátricas. MATERIAL Y MÉTODO: Se analizaron 566 episodios clínicos cuyo principal motivo de consulta estaba relacionado con un problema de salud mental, entre las 122.985 consultas a urgencias de pediatría entre 2015-2017. Psiquiatras exper­tos los agruparon en el Grupo CA (conductas autolesivas) y Grupo PS (otra psicopatología). Variables clínicas y sociode­mográficas se extrajeron de los informes de alta a partir de hojas de registro específicas. RESULTADOS: El Grupo CA incluyó el 20,5 % de las con­sultas a urgencias por algún problema de salud mental. Las conductas autolesivas más frecuentes fueron las sobreingestas medicamentosas (38,8 %) y los cortes (24,1 %). En relación al Grupo PS, el Grupo CA presentaba un porcen­taje mayor de chicas, una edad media más alta y más an­tecedentes psiquiátricos (p < 0,001). Además, este grupo presentó un mayor porcentaje de diagnósticos al alta de trastornos afectivos y posibles trastornos de la personali­dad (p < 0,001). CONCLUSIONES: La prevalencia de conductas autolesivas entre las consultas a urgencias pediátricas es alta. Se observan especialmente en chicas adolescentes y muestran una mayor complejidad clínica. La detección y atención adecuada de es­tas conductas con programas especializados puede ayudar a prevenir el deterioro del funcionamiento psicosocial y detec­tar precozmente el debut de trastornos psiquiátricos

INTRODUCTION: Self-harm in the paediatric population is an emerging problem that has been associated with disability and an increased risk of suicide. The objective of the study is to analyse the prevalence of self-harming behaviour as a reason for paediatric emergency consultations. MATERIALS AND METHODS: 122,985 paediatric emergency consultations during the years 2015-2017 were reviewed. Of these, 566 clinical episodes with a psychopathological prob­lem as the main reason for consultation were analysed. Ex­pert psychiatrists grouped them into Group CA (self-harming behaviour) and Group PS (other psychopathology). Clinical and sociodemographic variables were taken from the dis­charge reports and transferred to specific record sheets. RESULTS: During the period analysed, a progressive de­crease in the age of patients attending the paediatrics emer­gency room for a psychopathological problem was observed (p < 0.001). Of these, 20.5% consulted for self-harming be­haviour. Group CA had more of psychiatric medical history, an older mean age and were mostly female (p < 0.001). Among self-harming behaviour, the most frequent were medication overdose (38.8%) and cuts (24.1%). At discharge, this group had a higher percentage of diagnoses of affective disorders and possible personality disorders (p < 0.001). CONCLUSIONS: The prevalence of self-harm as the reason for consultation in emergency services is high in the paediatric population and adequate attention should be paid to it, especially for adolescent girls. To prevent the functional deterioration associated with these behaviours, implementing programmes for early detection and intervention and referral to specialised treatment should be considered