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Pediatrics Digest

机译:儿科文摘

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Although concussion is increasingly being diagnosed in the pediatric population, little is known about what factors lead to prolonged postconcussive symptoms in children. In particular, the effect of previous history of concussion on recovery from a repeat injury is unclear.Children with a history of previous concussion, particularly recent or multiple concussions, are at increased risk for prolonged symptoms after concussion. This suggests that repeat concussion, particularly within a vulnerable time window, may lead to longer duration of symptoms.Medication ingestions are increasing among children despite a number of public health interventions. The majority of these poisonings are related to prescription as opposed to over-the-counter medications.Rising rates of poisonings in children are strongly correlated with rising use of hypoglycemics, antihyperlipidemics, β-blockers, and opioids among adults. These events are associated with considerable health care utilization, both in terms of emergency department visits and hospital admissions.Bronchiolitis is often cited as the leading cause of hospitalization for young children in the United States Previous studies reported increases in bronchiolitis hospitalizations through the 1990s. There are no recent efforts to assess national trends in bronchiolitis incidence and health care utilization.Between 2000 and 2009, we found a significant decline in bronchiolitis hospitalizations among US children. By contrast, use of mechanical ventilation and hospital charges for bronchiolitis significantly increased over this same period.Exemption rates for immunization requirements have until recently been stable in states permitting religious exemptions. States with easy exemption processes have seen higher rates of vaccine-preventable diseases.In New York, the rate of religious exemptions has increased. Counties with higher rates of exemption have a greater incidence of pertussis.Parent or provider reluctance to immunize infants during sick visits is a common reason why infants fall behind on the recommended schedule. One previous study suggested that immunizations at sick visits …
机译:尽管在儿童人群中脑震荡越来越多地被诊断出来,但对于导致儿童长期脑震荡后症状的因素知之甚少。尤其是,先前脑震荡史对重伤恢复的影响尚不清楚。具有先前脑震荡史的儿童,特别是近期或多次脑震荡的儿童,脑震荡后长期症状的风险增加。这表明反复的脑震荡,尤其是在脆弱的时间窗口内,可能会导致症状持续时间更长。尽管有许多公共卫生干预措施,儿童中的药物摄入仍在增加。这些中毒大多数与处方药有关,而不是非处方药。儿童中毒率上升与成年人降糖药,降血脂药,β受体阻滞剂和阿片类药物的使用量增加密切相关。这些事件在急诊就诊和住院方面均与相当大的卫生保健利用率有关。在美国,毛细支气管炎经常被认为是导致儿童住院的主要原因,以前的研究报道,到1990年代,毛细支气管炎的住院治疗有所增加。最近没有任何努力来评估细支气管炎发病率和医疗保健利用的国家趋势。2000年至2009年间,我们发现美国儿童的细支气管炎住院治疗显着下降。相比之下,在同一时期,机械通气和支气管炎的住院费用显着增加。直到最近,在允许宗教豁免的州,免疫要求的豁免率一直稳定。豁免程序容易的州疫苗可预防疾病的比率更高。在纽约,宗教豁免率有所提高。豁免率较高的县发生百日咳的几率更高。父母或服务提供者不愿在病假期间免疫婴儿是导致婴儿未能按照推荐的时间表进行免疫的常见原因。先前的一项研究表明,在病假期间进行免疫接种……

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