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Pediatrics Digest

机译:儿科文摘

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Violence involving firearms is a leading cause of death among US youth ages 14 to 24. The emergency department is the primary medical setting for care of assault-injured youth and an underused but important setting for violence-prevention programs.Among assault-injured youth seeking emergency department care, firearm possession rates are high, most obtained outside of legal channels. Higher rates of negative retaliatory attitudes and substance use among those youth with firearms increases risk of future lethal violence.Among infants with birth weights of 501 to 1500 g born between 2000 and 2009, mortality and major morbidities among survivors declined.Obstetrical and neonatal care practices for infants 501 to 1500 g changed significantly from 2000 and 2009, particularly decreased conventional ventilation and use of steroids for chronic lung disease and increased nasal continuous positive airway pressure and surfactant treatment after delivery.Diabetic ketoacidosis (DKA) is a short-term complication of type 1 diabetes and is a major cause of preventable hospitalization in children. Hospital resource utilization and readmission rates for DKA across the US are not known.Readmission for DKA within a year of hospitalization is common, accounting for one-fifth of all DKA admissions. Resource use, hospital length of stay, and readmission rates vary widely across major US children’s hospitals, even after adjusting for hospital differences in patients.There is wide variation in testing and treatment of children hospitalized with pneumonia. Limited data are available on diagnostic testing patterns and the association of test utilization with disposition outcomes for children with pneumonia evaluated in the emergency department (ED).Significant variation exists in testing for pediatric pneumonia. EDs that use more testing have higher hospitalization rates. However, ED revisit rates were not significantly different between high- and low-utilizing EDs, suggesting an opportunity to reduce testing without negatively affecting outcomes.Variation in the emergency department …
机译:在美国14至24岁的年轻人中,涉及枪支的暴力行为是导致死亡的主要原因。急诊部门是照料受伤青年的主要医疗场所,也是预防暴力计划中未充分利用但重要的场所。急诊部门的照顾,枪支拥有率很高,多数是通过合法渠道获得的。持有枪支的年轻人对报复态度和物质使用的否定率更高,这增加了未来致命的暴力风险.2000年至2009年之间出生的体重在501至1500 g的婴儿中,幸存者的死亡率和主要发病率下降了。从2000年到2009年,婴儿501至1500 g发生了显着变化,特别是常规通气的减少和类固醇用于慢性肺疾病的使用以及分娩后鼻腔持续正气道正压和表面活性剂治疗的增加。糖尿病酮症酸中毒(DKA)是糖尿病的短期并发症1型糖尿病,是儿童可预防住院的主要原因。在美国各地,DKA的医院资源利用率和再入院率尚不清楚。住院一年内DKA的再入院率很普遍,占所有DKA入院人数的五分之一。即使调整了患者的医院差异,美国主要儿童医院的资源使用,住院时间和再入院率也有很大差异。肺炎住院儿童的测试和治疗差异很大。在急诊科(ED)中评估的诊断性测试模式以及测试利用率与肺炎患儿的处置结局之间的联系的数据有限。小儿肺炎的测试存在显着差异。使用更多测试的ED的住院率更高。但是,高利用率和低利用率的ED之间的ED复诊率没有显着差异,这表明有机会减少测试,而不会对结果产生负面影响。急诊室的变化……

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