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Jones IE, Williams SM, Dow N, Goulding A. How many children remain fracture-free during growth? a longitudinal study of children and adolescents participating in the Dunedin Multidisciplinary Health and Development Study. Osteoporos Int 2002; 13:990-5. [PMID: 12459942 DOI: 10.1007/s001980200137] [Citation(s) in RCA: 180] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Indexed: 11/30/2022]
Abstract
While much is known regarding the incidence and pattern of fractures during growth, information is sparse as to how many children fracture repeatedly and how many remain fracture-free during growth. The Dunedin Multidisciplinary Health and Development Study, a birth cohort, whose members were questioned regularly throughout growth (at ages 5, 7, 9, 11, 13, 15 and 18 years) concerning injuries including fractures, has provided a unique opportunity to answer these questions. Life-table analysis showed that approximately half the children remained fracture-free throughout growth [girls 60.1%, (95% CI 54.7-65.0) and boys 49.3% (95% CI 44.0-54.4)]. Data on fracture history, for participants seen at every phase, was available for 601 members through to the age of 18 years (61.1% of the cohort seen at age 5 years). Two hundred and ninety-one of these 601 participants reported 498 fractures, with 172 sustaining a single fracture, and 119 more than one fracture (15.8% girls and 23.4% boys). The most common site of fracture was the wrist/forearm (24.1% of all fractures). We conclude that although bone fractures are a common adverse event in childhood, half of all children remain fracture-free throughout growth.
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Abstract
OBJECTIVES (1) For crashes on a public road, to compare serious cyclist crashes involving a motor vehicle with cyclist crashes not involving a motor vehicle, in terms of threat to life and length of stay in hospital. (2) To determine the proportion of all serious crashes involving cyclists on public roads which are recorded by the police. (3) To determine the degree to which under-reporting of serious crashes involving cyclists and motor vehicles on public roads is associated with various demographic, environmental, and injury factors. STUDY DESIGN Records for the period 1995-99, of cyclists seriously injured on a public road and hospitalised were linked to the traffic crash report (TCR) database maintained by Land Transport Safety Authority (LTSA). RESULTS Of the 2925 cyclist crashes on public roads, only 652 (22%) could be linked to a TCR. Of the crashes involving motor vehicles (n = 1033), only 562 (54%) could be linked to the LTSA database. Age, ethnicity, injury severity, and cumulative length of stay were the only variables that predicted whether hospitalised cycle crash cases were more likely to have a corresponding TCR. There were substantial numbers of cyclist only crashes which typically are not captured in the TCR database. Nine percent of these resulted in serious or worse injury (that is, International Classification of Diseases/abbreviated injury scale score of 3+) and 7% resulted in hospital stays greater than seven days. CONCLUSION Greater effort and precision needs to be applied to routinely document the burden of cyclist crashes, especially cyclist only crashes.
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Research Support, Non-U.S. Gov't |
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Stamatos NM, Gomatos PJ, Cox J, Fowler A, Dow N, Wohlhieter JA, Cross AS. Desialylation of peripheral blood mononuclear cells promotes growth of HIV-1. Virology 1997; 228:123-31. [PMID: 9123818 DOI: 10.1006/viro.1996.8373] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 02/04/2023]
Abstract
Activation of peripheral blood CD4+ helper T lymphocytes establishes a permissive state for growth of HIV-1. Activated T lymphocytes expressed increased sialidase (neuraminidase) activity and were hyposialylated. Treatment of freshly isolated peripheral blood mononuclear cells (PBMCs) with microbial neuraminidase (NANase) or phytohemagglutinin (PHA) prior to infection at low multiplicity with T cell line-adapted HIV-1IIIB resulted in production of large amounts of p24 antigen and reverse transcriptase. In contrast, neither viral component was detected in the medium of mock-treated cells infected at a similar multiplicity through 21 days in culture. The titer of a stock solution of HIV-1IIIB was 1.4 +/- 0.18 log10 greater in NANase-treated PBMCs than in mock-treated cells; the titer was similarly raised 1.5 to 1.76 +/- 0.18 log10 in PHA-treated cells. Growth of the primary isolate HIV-1(91/US/056) was also enhanced in NANase-treated PBMCs; the titer of a stock solution of HIV-1(91/US/056 was 1.0 +/- 0.16 log10 greater in NANase-treated PBMCs than in mock-treated cells 7 days after infection. No enhancement of viral growth in PBMCs was detected when NANase was heat-inactivated or specifically inhibited with 2,3-dehydro-2-desoxy-N-acetyl-neuraminic acid prior to use. Treatment of PBMCs with NANase did not alter the distribution of lymphocyte subsets nor change the density of CD4 antigen per cell after 7 days in culture. Whereas PHA treatment of PBMCs was mitogenic, pretreatment with NANase was not; the amount of [3H]thymidine incorporated into DNA and culture growth characteristics were similar for NANase- and mock-treated cells. Thus, desialylation of PBMCs promoted a permissive state for growth of HIV-1 without affecting the rate of DNA synthesis or relative number of target CD4+ cells.
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Abstract
An 85-year-old man with unexplained hemorrhagic pseudoascites of four years' duration was discovered to have a primary omental leiomyosarcoma. Neoplasms arising in the greater omentum are rare. To date, only three primary omental leiomyosarcomas have been described. Clinical and pathologic findings of this case are presented and the topic of primary omental neoplasms is reviewed.
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Case Reports |
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Yeates KO, Tang K, Barrowman N, Freedman SB, Gravel J, Gagnon I, Sangha G, Boutis K, Beer D, Craig W, Burns E, Farion KJ, Mikrogianakis A, Barlow K, Dubrovsky AS, Meeuwisse W, Gioia G, Meehan WP, Beauchamp MH, Kamil Y, Grool AM, Hoshizaki B, Anderson P, Brooks BL, Vassilyadi M, Klassen T, Keightley M, Richer L, DeMatteo C, Osmond MH, Zemek R, Xie J, Chatfield J, Dow N, Papadimitropoulos R, Levesque T, Langford C, Tran TT, McGahern C, DiGirolamo V, Mazza J, Lagacé M, Cook R, Fitzpatrick E, MacIntyre J, Moore J. Derivation and Initial Validation of Clinical Phenotypes of Children Presenting with Concussion Acutely in the Emergency Department: Latent Class Analysis of a Multi-Center, Prospective Cohort, Observational Study. J Neurotrauma 2019; 36:1758-1767. [DOI: 10.1089/neu.2018.6009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 11/13/2022] Open
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Abstract
Shared haplotypes have been documented in three of the four previously reported families with familial hairy cell leukemia (HCL). Human leukocyte antigen (HLA) typing was done on a four-member sibship in which two siblings had hairy cell leukemia. The two affected siblings share the haplotype A2; Bw6, Bw62(15); Cw1; DR4, DRw53; DQw3. No one HLA antigen or haplotype is common among the five families reported at this time. These limited data suggest HCL is not associated with a specific HLA antigen. HLA typing of a larger collection of cases of familial HCL may help better define what role, if any, inheritance plays in the occurrence of this rare disorder among numerous first degree relatives.
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Case Reports |
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Newton AS, Rathee S, Grewal S, Dow N, Rosychuk RJ. Children's Mental Health Visits to the Emergency Department: Factors Affecting Wait Times and Length of Stay. Emerg Med Int 2014; 2014:897904. [PMID: 24563785 PMCID: PMC3915921 DOI: 10.1155/2014/897904] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 06/14/2013] [Revised: 12/02/2013] [Accepted: 12/10/2013] [Indexed: 11/20/2022] Open
Abstract
Objective. This study explores the association of patient and emergency department (ED) mental health visit characteristics with wait time and length of stay (LOS). Methods. We examined data from 580 ED mental health visits made to two urban EDs by children aged ≤18 years from April 1, 2004, to March 31, 2006. Logistic regressions identified characteristics associated with wait time and LOS using hazard ratios (HR) with 95% confidence intervals (CIs). Results. Sex (male: HR = 1.48, 95% CI = 1.20-1.84), ED type (pediatric ED: HR = 5.91, 95% CI = 4.16-8.39), and triage level (Canadian Triage and Acuity Scale (CTAS) 2: HR = 3.62, 95% CI = 2.24-5.85) were statistically significant predictors of wait time. ED type (pediatric ED: HR = 1.71, 95% CI = 1.18-2.46), triage level (CTAS 5: HR = 2.00, 95% CI = 1.15-3.48), number of consultations (HR = 0.46, 95% CI = 0.31-0.69), and number of laboratory investigations (HR = 0.75, 95% CI = 0.66-0.85) predicted LOS. Conclusions. Based on our results, quality improvement initiatives to reduce ED waits and LOS for pediatric mental health visits may consider monitoring triage processes and the availability, access, and/or time to receipt of specialty consultations.
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research-article |
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Gray SR, Dow N, Orbell JD, Tran T, Bolto BA. The significance of interactions between organic compounds on low pressure membrane fouling. WATER SCIENCE AND TECHNOLOGY : A JOURNAL OF THE INTERNATIONAL ASSOCIATION ON WATER POLLUTION RESEARCH 2011; 64:632-639. [PMID: 22097041 DOI: 10.2166/wst.2011.488] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Academic Contribution Register] [Indexed: 05/31/2023]
Abstract
Fouling of hollow fibre microfiltration and ultrafiltration membranes by solutions of pure organic compounds and mixtures of these compounds was studied with a backwashable membrane filtration apparatus. Small molecular weight compounds resulted in little fouling, while their polymeric analogues resulted in more severe fouling. Neutrally charged dextran resulted in minor, irreversible fouling, that was considered to be associated with blocking of small pores. Cationically charged chitosan produced gross fouling for which the extent of reversibility increased with salt addition. Anionically charged alginic acid resulted in gross irreversible fouling, except when being filtered by a hydrophilic membrane in the absence of calcium where a high degree of flux recovery was observed. Calcium addition to the alginic acid solutions resulted in gross fouling of all membranes and calcium bridging was considered to be responsible for this behaviour. Greater fouling occurred on the hydrophilic membrane compared to the hydrophobic membranes for bovine serum albumin (BSA) solutions, and this was considered to be due to physical blocking of pores, because addition of calcium resulted in lower flux declines. Addition of BSA and calcium to alginic acid solutions resulted in lower flux recoveries for the alginic acid system, consistent with the proposition that interactions between polysaccharide and other compounds are required for irreversible fouling on hydrophilic membranes.
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Newton AS, Dow N, Dong K, Fitzpatrick E, Cameron Wild T, Johnson DW, Ali S, Colman I, Rosychuk RJ. A randomised controlled pilot trial evaluating feasibility and acceptability of a computer-based tool to identify and reduce harmful and hazardous drinking among adolescents with alcohol-related presentations in Canadian pediatric emergency departments. BMJ Open 2017; 7:e015423. [PMID: 28801399 PMCID: PMC5724197 DOI: 10.1136/bmjopen-2016-015423] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Academic Contribution Register] [Received: 12/06/2016] [Revised: 06/13/2017] [Accepted: 07/05/2017] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study piloted procedures and obtained data on intervention acceptability to determine the feasibility of a definitive randomised controlled trial (RCT) of the effectiveness of a computer-based brief intervention in the emergency department (ED). DESIGN Two-arm, multi-site, pilot RCT. SETTING AND PARTICIPANTS Adolescents aged 12-17 years presenting to three Canadian pediatric EDs from July 2010 to January 2013 for an alcohol-related complaint. INTERVENTIONS Standard medical care plus computer-based screening and personalised assessment feedback (experimental group) or standard care plus computer-based sham (control group). ED and research staff, and adolescents were blinded to allocation. OUTCOMES Main: change in alcohol consumption from baseline to 1- and 3 months post-intervention. Secondary: recruitment and retention rates, intervention acceptability and feasibility, perception of group allocation among ED and research staff, and change in health and social services utilisation. RESULTS Of the 340 adolescents screened, 117 adolescents were eligible and 44 participated in the study (37.6% recruitment rate). Adolescents allocated to the intervention found it easy, quick and informative, but were divided on the credibility of the feedback provided (agreed it was credible: 44.4%, disagreed: 16.7%, unsure: 16.7%, no response: 22.2%). We found no evidence of a statistically significant relationship between which interventions adolescents were allocated to and which interventions staff thought they received. Alcohol consumption, and health and social services data were largely incomplete due to modest study retention rates of 47.7% and 40.9% at 1- and 3 months post-intervention, respectively. CONCLUSIONS A computer-based intervention was acceptable to adolescents and delivery was feasible in the ED in terms of time to use and ease of use. However, adjustments are needed to the intervention to improve its credibility. A definitive RCT will be feasible if protocol adjustments are made to improve recruitment and retention rates; and increase the number of study sites and research staff. TRIAL REGISTRATION clinicaltrials.gov NCT01146665.
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Multicenter Study |
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Ali S, Ma K, Dow N, Vandermeer B, Scott S, Beran T, Issawi A, Curtis S, Jou H, Graham TAD, Sigismund L, Hartling L. A randomized trial of iPad distraction to reduce children's pain and distress during intravenous cannulation in the paediatric emergency department. Paediatr Child Health 2021; 26:287-293. [PMID: 34630780 PMCID: PMC8496185 DOI: 10.1093/pch/pxaa089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 04/21/2020] [Accepted: 07/07/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES We compared the addition of iPad distraction to standard care, versus standard care alone, to manage the pain and distress of intravenous (IV) cannulation. METHODS Eighty-five children aged 6 to 11 years requiring IV cannulation (without child life services present) were recruited for a randomized controlled trial from a paediatric emergency department. Primary outcomes were self-reported pain (Faces Pain Scale-Revised [FPS-R]) and distress (Observational Scale of Behavioral Distress-Revised [OSBD-R]), analyzed with two-sample t-tests, Mann-Whitney U-tests, and regression analysis. RESULTS Forty-two children received iPad distraction and 43 standard care; forty (95%) and 35 (81%) received topical anesthesia, respectively (P=0.09). There was no significant difference in procedural pain using an iPad (median [interquartile range]: 2.0 [0.0, 6.0]) in addition to standard care (2.0 [2.0, 6.0]) (P=0.35). There was no significant change from baseline behavioural distress using an iPad (mean ± SD: 0.53 ± 1.19) in addition to standard care (0.43 ± 1.56) (P=0.44). Less total behavioural distress was associated with having prior emergency department visits (odds ratio [95% confidence interval]: -1.90 [-3.37, -0.43]) or being discharged home (-1.78 [-3.04, -0.52]); prior hospitalization was associated with greater distress (1.29 [0.09, 2.49]). Significantly more parents wished to have the same approach in the future in the iPad arm (41 of 41, 100%) compared to standard care (36 of 42, 86%) (P=0.03). CONCLUSIONS iPad distraction during IV cannulation in school-aged children was not associated with less pain or distress than standard care alone. The effects of iPad distraction may have been blunted by topical anesthetic cream usage. CLINICAL TRIALS REGISTRATION ClinicalTrials.gov: NCT02326623.
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research-article |
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Elsohaby I, McClure JT, Dow N, Keefe GP. Effect of Heat-treatment on Accuracy of Infrared Spectroscopy and Digital and Optical Brix Refractometers for Measuring Immunoglobulin G Concentration in Bovine Colostrum. J Vet Intern Med 2017; 32:491-496. [PMID: 29280196 PMCID: PMC5787164 DOI: 10.1111/jvim.15025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 05/08/2017] [Revised: 10/25/2017] [Accepted: 11/21/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Heat-treatment of colostrum is a method developed to reduce calf exposure to pathogens. Infrared (IR) spectroscopy and Brix refractometers can be used for measuring colostral IgG concentration and assessing colostrum quality. OBJECTIVES To determine the impact of heat-treatment on accuracy of IR spectroscopy and Brix refractometers for measuring colostral IgG concentration and assessing colostrum quality before and after heat-treatment. ANIMALS A total of 60 Holstein dairy cows on 8 commercial dairy farms. METHODS A cross-sectional study was designed to determine the effect of heat-treatment at 60°C and 63°C each for 30 and 60 minutes duration on colostral IgG concentration measured by the reference radial immunodiffusion (RID) assay, IR spectroscopy, and digital and optical refractometers. RESULTS Colostrum IgG concentration significantly decreased after heat-treatment at 63°C for 30 or 60 minutes as measured by RID, but the IgG values remained unchanged when measured by IR spectroscopy and refractometers. The lowest correlation coefficient found between IR spectroscopy (r = 0.70) and RID results was in colostrum heat-treated at 63°C for 60 minutes. For digital (r = 0.48) and optical (r = 0.50) refractometers, the lowest correlation coefficient was at 63°C for 30 minutes when compared to RID. The accuracy of the IR spectroscopy, digital and optical Brix refractometers was decreased from 91.7 to 80%, 81.7 to 45%, and 80 to 45%, respectively, when colostrum heat-treated at 63°C for 60 minutes. CONCLUSIONS AND CLINICAL IMPORTANCE Radial immunodiffusion, IR spectroscopy, and Brix refractometers exhibit utility for measuring IgG concentration when colostrum heat-treated at 60°C but does not detect decrease IgG concentrations when heat-treated at 63°C.
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Journal Article |
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McGrath T, Ali S, Dow N, Aziz S, Pilarski M, Drendel AL. A qualitative study of the language of satisfaction in children with pain. Paediatr Child Health 2017; 23:e62-e69. [PMID: 30038534 DOI: 10.1093/pch/pxx174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 11/12/2022] Open
Abstract
Background Measures of satisfaction are essential to understanding patient experience, in general, and particularly with pain management. Objectives (A) To identify the words children commonly use to communicate satisfaction, in general, and for pain management and (B) to determine if this vocabulary matches their caregivers. Methods A study of child-caregiver pairs seen at a paediatric emergency department (PED) from July to November 2014 was conducted. Children were interviewed using ten open-ended questions. Grounded theory was employed for data coding and analysis. Caregivers completed a written survey. Results A total of 105 child interviews were completed (n=53 females, mean age 9.91, SD 3.71, age range 4 to 16); 105 caregiver surveys were completed (n=80 females). Children (n=99) most commonly used 'good', 'better' and 'happy' to express satisfaction with pain management (27%, 21% and 22%, respectively), with PED care (31%, 14% and 33%) and in general (13%, 5% and 49%). Children (n=99) used the words 'sad', 'bad' and 'not good' to communicate dissatisfaction with pain management (21%, 7% and 11%, respectively) and with PED care (21%, 13% and 12%). Only 56% of children (55/99) were familiar with the word 'satisfaction'. Children's word choices were similar to their caregivers' word choices, 14% (14/99) of the time. Conclusion Children use simpler words than their caregivers, including good, better and happy, when communicating satisfaction. A child's vocabulary is seldom the same as the vocabulary their caregiver uses, therefore caregiver vocabulary should not be used as a surrogate for paediatric patients. The word 'satisfaction' should be avoided, as most children lack understanding of the term.
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Journal Article |
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Baker J, Dow N, Toro L, Clark L, Wright D. 233 Flow cytometric quantitation of peripheral blood lymphocytes expressing human immunodeficiency virus (HIV)-antigens in individuals infected with HIV. J Allergy Clin Immunol 1988. [DOI: 10.1016/0091-6749(88)90468-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 10/25/2022]
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Dow N. CD8/CD57 lymphocytosis in common variable immunodeficiency. Blood 1991; 77:1400-1. [PMID: 1705840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 12/28/2022] Open
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Letter |
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Ali S, Maki C, Xie J, Lee B, Graham T, Vanderkooi O, MacDonald S, Poonai N, Thull-Freedman J, Rajagopal M, Dow N, Sivakumar M, Freedman S. 112 Characterizing Pain in Children with Acute Gastroenteritis in the Emergency Department. Paediatr Child Health 2019. [DOI: 10.1093/pch/pxz066.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Indexed: 11/14/2022] Open
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Rajagopal M, Kundra M, Mabood N, Ali S, Rankin T, Dow N, Craig W. Paediatric injuries due to falls from windows and balconies: an 8-year prospective and retrospective review. Paediatr Child Health 2020; 26:e222-e228. [PMID: 34630781 DOI: 10.1093/pch/pxaa090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Academic Contribution Register] [Received: 04/20/2020] [Accepted: 07/03/2020] [Indexed: 11/12/2022] Open
Abstract
Background Unintentional falls from windows and balconies pose a serious health risk to children. Limited Canadian data describing such falls currently exist. This study aimed to describe the frequency, demographic characteristics, injury patterns, and risk factors associated with paediatric falls from windows and balconies. Methods This study employed both prospective data collection and retrospective medical record review. Prospectively, consenting families were enrolled from February 2015 to February 2017; retrospectively, charts from January 2009 to December 2014 were reviewed. Children 0 to 16 years of age, who presented to the Stollery Children's Hospital (Edmonton, Alberta) emergency department due to a fall from a window or balcony, were included. Results A total of 102 children were included; thirty were enrolled prospectively and 72 retrospectively. Median age was 4.5 years (interquartile range 2.83 to 6.83) with 63.7% (65 of 102) males. About 87.2% (89 of 102) of falls were from windows and 12.8% (13 of 102) from balconies. The median estimated height of fall was 4.1 m (interquartile range 3.04 to 4.73). About 58.4% (59 of 101) had at least one major injury (i.e., concussion, fractured skull, internal injury, fractured limb, severe laceration), 36.6% had minor injuries only (i.e., abrasions, contusions, sprains), and 5.0% had no documented injuries. There were no fatalities. About 30.4% (31 of 102) were admitted, with 48.4% of these children (15 of 31) requiring surgery. Conclusion Most falls from windows and balconies occurred in children under the age of 5 years and were associated with serious morbidity, high admission rates, and need for surgery. Child supervision as well as installation of key safety features in windows may help minimize paediatric fall-related injuries.
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