Coffee break - Epidemiologic analysis, traditions & holidays that increase burn risk of pediatric patients.

BACKGROUND: Burns are estimated to cause up to 1% of admissions to emergency department in low- and middle-income countries, and up to 220 admissions per 100 K people in high income countries. Knowing the special features in every population could help formulate prevention strategies tailored for the specific group targeted and thus help decrease the incidence of burns in the general population. PATIENTS AND METHODS: We examined all patients files admitted to the Rappaport hospital within Rambam Medical Center between the years 2012-2016. RESULTS: Male admissions accounted for 57% (18.1 per 100 K life years) of all admissions. Scald was the most prominent cause of burn in all the cohort subgroups, with 65% of all burns. The specific cause of scald varied in the subgroups. Burns usually happened during weekend (p < 0.001). Transition seasons, i.e. autumn and spring, were the most dangerous for our cohort (p < 0.001). CONCLUSIONS: Pediatric burn patterns were found correlate to population, timing, and customs. Mapping the hazardous rituals that may cause burns in different populations, is the first step towards prevention.

Morel Lavallée Lesion - A case report and review of literature.

INTRODUCTION: Morel-Lavallée lesion (MLL) is an uncommon entity, by which shearing forces result in a closed degloving lesion. This can result in an infected hematoma and lead to a life-threatening situation. PRESENTATION OF CASE: We present a case of a 59-year-old patient who presented to our emergency department. This patient had a crushing injury, and later was found to have an infected MLL. The patient was treated with surgical drainage, and 2 split thickness skin grafts. The patient fully healed. DISCUSSION: We review the current literature regarding MLL and diagnostic tools in order to accurately and rapidly diagnose this often-missed entity. Special emphasis is given to the treatment of MLL, with the current knowledge as reflected in the literature. CONCLUSIONS: It is important for caregivers to know the diagnostic steps and pitfalls of this elusive diagnosis in order to diagnose and treat MLL quickly, before it turns into a life-threatening state for the patient.

Iatrogenic intracranial hypotension and cerebral venous thrombosis.

OBJECTIVE: To assess the manifestations of cerebral venous thrombosis (CVT) associated with intracranial hypotension (IH) following lumbar puncture (LP) or spinal anesthesia (SA). METHODS: Adult patients with acute CVT unrelated to infection, neurosurgery, or otolaryngological surgery were identified. CVT manifesting within 21days after LP/SA was considered associated with iatrogenic IH. Presentation of patients with and without associate IH was compared. RESULTS: 42 patients were included. 11/42 who had undergone LP/SA presented symptoms and imaging characteristics of IH; 31 had no evidence of IH. Those with IH were more often females (11/11 vs. 21/31, p=0.03), presented sooner after symptom onset (6.0±2.2 vs. 15.6±14days, p=0.002), and rates of venous infarction (45% vs. 23%) and seizures (27% vs. 10%) appeared somewhat elevated (p<0.15). Patients with CVT associated with IH had significantly more cortical vein thrombi (55% vs. 16%, p=0.02). Thrombi were significantly shorter in patients with IH (102±113mm vs. 246±133mm, p=0.002). CONCLUSION: Patients with CVT secondary to IH were typically younger females, and presented with a more acute and severe course with frequent venous infarcts. Although thrombi in the IH group were less extensive, they were more often symptomatic.