ABSTRACT
Apparent Life-Threatening Events [ALTEs] is an episode that is frightening to the observer and is characterized by some combination of apnea, color change, altered muscle tone, choking, and gagging. This study was designed to evaluate and follow up neonates who presented with clinical manifestation of an ALTE in a year. In this prospective observational study, all of the neonates with episode of ALTE who were admitted to the Children's Medical Center [CMC] in Tehran, from June 15[th] 2010 to May 14[th] 2011 were enrolled in the study. Data from patients consisting of history, physical examinations, and paraclinical findings were recorded in a checklist and all followed up 3 to 6 months after discharge. During the study period 18 neonates were admitted due to ALTE episode[s] with mean age of 15 +/- 13 days. Nine [50%] neonates had previous attacks of ALTE. The most frequent complaint was cyanosis in 12 [67%] and apnea in 8 [44%] patients. In 10 [56%] the event lasted less than one minute, 13 [72%] were awake, 17 [95%] in supine position and 13 [72%] on their parent's lap. Primary antagonistic impression on admission was sepsis in 11 [61%] and concomitant seizure in 5 [28%]. The most common final diagnosis according to repeated physical examinations, result of paraclinical investigations and follow up was sepsis 4 [22%] and aspiration 9 [50%]. ALTE recurred in none of the neonates during follow up. The rate of ALTE seems to be higher than in this study owing to high incidence of recurrent ALTE. Although most of these attacks regress spontaneously, more attention should be paid for the underlying diseases
Subject(s)
Humans , Female , Male , Brief, Resolved, Unexplained Event/etiology , Infant, Newborn , Airway Obstruction/mortality , Apnea/mortality , Cyanosis , Hospitals, Pediatric , Emergency Service, Hospital , Gagging , Patient Admission , Recurrence , Prospective StudiesABSTRACT
CONTEXT AND OBJECTIVE Analysis on accidents from the perspective of population segments shows there is higher incidence among children, adolescents and young adults. Since the characteristics and circunstances of the event are closely related to educational, economic, social and cultural issues, identifying them may contribute towards minimizing the causes, which are often fatal. The aim here was to identify the environmental, chemical, biological and cultural factors associated with deaths due to accidents among children, adolescents and young adults in Cuiabá, in 2009. DESIGN AND SETTING This was a descriptive cross-sectional study conducted in Cuiabá, Mato Grosso, Brazil. RESULTS Thirty-nine accidental deaths of individuals aged 0 to 24 years were examined: 56.4% due to traffic accidents; 25.6%, drowning; 10.3%, aspiration of milk; 5.1%, falls; and 2.6%, accidentally triggering a firearm. Male victims predominated (82.1%). The presence of chemical, environmental and biological risk factors was observed in almost all of the homes. Regarding cultural factors and habits, a large proportion of the families had no idea whether accidents were foreseeable events and others did not believe that the family's habits might favor their occurrence. Delegation of household chores or care of younger siblings to children under the age of 10 was common among the families studied. CONCLUSION The results point towards the need to have safe and healthy behavioral patterns and environments, and to monitor occurrences of accidents, thereby structuring and consolidating the attendance provided for victims. .
CONTEXTO E OBJETIVO Ao analisar os acidentes sob o prisma dos segmentos populacionais, observa-se grande incidência em crianças, adolescentes e jovens. A frequência e as características e circunstâncias do evento estão intimamente relacionadas com fatores educacionais, econômicos, sociais e culturais, e a identificação desses fatores pode contribuir para minimizar essas causas, muitas vezes fatais. O objetivo foi identificar os fatores ambientais, químicos, biológicos e culturais associados com óbitos por acidentes, ocorridos entre crianças, adolescentes e jovens em Cuiabá, em 2009. TIPO DE ESTUDO E LOCAL Este é um estudo descritivo, transversal, realizado em Cuiabá, Mato Grosso, Brasil. RESULTADOS Foram analisados 39 óbitos acidentais ocorridos de 0 a 24 anos (56,4% por acidente de transporte, 25,6% por afogamento, 10,3% por aspiração de leite, 5,1% por queda e 2,6% por disparo acidental de arma de fogo). Houve predomínio no sexo masculino (82,1%). Observou-se a presença de fatores químicos, ambientais e biológicos na quase totalidade das residências. Quanto aos fatores culturais e hábitos, grande parte das famílias não soube referir se o acidente constitui evento previsível e outra parte não acredita que os hábitos da família favorecem sua ocorrência. Delegar aos filhos menores de 10 anos os afazeres domésticos ou o cuidado de irmãos menores é comum entre as famílias estudadas. CONCLUSÃO Os resultados apontam para a necessidade de adotar comportamentos e ambientes seguros e saudáveis, bem como monitorizar a ocorrência dos acidentes, estruturando e consolidando o atendimento às vítimas. .
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Young Adult , Accidents/mortality , Accidental Falls/mortality , Accidents, Traffic/mortality , Age Distribution , Airway Obstruction/mortality , Brazil , Cause of Death , Cross-Sectional Studies , Drowning/mortality , Risk Factors , Sex Distribution , Socioeconomic Factors , Time Factors , Wounds, Gunshot/mortalityABSTRACT
Se considera la segunda causa más frecuente de muerte accidental en niños, después de los accidentes automovilísticos. Del 55 al 60 por ciento de las muertes por ahogamiento se presentan en los menores de veinte años, entre el 40 y el 50 por ciento de los casos ocurren en niños entre 0 y 4 años, siendo más frecuente en niños de 1 y 2 años de edad. Los que tienen lugar fuera del domicilio familiar, son más frecuentes en varones, en proporción de 3 a 1. La raza negra se ahoga 2 veces más que la blanca. Casi el 50 por ciento de las muertes se producen en lagos, estanques y ríos, aunque las piscinas privadas contribuyen a la mayor parte de los accidentes de inmersión en algunos lugares. Con menor frecuencia el ahogamiento tiene lugar en tinas de baño, tanques y otros sitios. La mayor parte de los accidentes de ahogamient(60 por ciento ocurren los fines de semana durante los meses de verano. Estudios americanos han mostrado que las piscinas privadas y las tinas de baño son los principales sitios del accidente con una mayor distribución de casos los días viernes, sábado y domingo así como los meses de vacaciones escolares. En Estados Unidos se calculan 8.000 muertes anuales de las cuales el 40 por ciento son niños...